Department of Orthopaedics, School of Medicine, Zhongda Hospital, Southeast University, No. 87 Ding Jia Qiao, Nanjing, 210009, Jiangsu, People's Republic of China.
School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.
World J Surg. 2022 Nov;46(11):2595-2606. doi: 10.1007/s00268-022-06690-y. Epub 2022 Aug 10.
With the increasing evidence provided by recent high-quality studies, the intravenous iron appears to be a reliable therapy for blood administration in geriatric patients with hip fractures. Here, this systematic review and meta-analysis were aimed to assess the effectiveness and safety of intravenous iron in geriatric patients sustaining hip fractures.
Potential pertinent literatures evaluating the effects of intravenous iron in the geriatric patients undergoing hip fractures were identified from Web of Science, PubMed, Embase, and Scopus. We performed a pairwise meta-analysis using fixed- and random-effects models, and the pooling of data was carried out by using RevMan 5.1.
Four randomized controlled trials and four observational studies conform to inclusion criteria. The results of meta-analysis showed that intravenous iron reduced transfusion rates compared to the control group, yet the result did not reach statistical significance. The intravenous iron was related to lower transfusion volumes, shorter length of stay, and a reduced risk of nosocomial infections. And there was no significant difference in terms of the mortality and other complications between the treatment group and the control group.
Current evidence suggests that intravenous iron reduces the transfusion volume, length of hospital stay, and risk of nosocomial infections. It takes about 7 days for intravenous iron to elevate hemoglobin by 1 g/dl and about 1 month for 2 g/dl. The safety profile of intravenous iron is also reassuring, and additional high-quality studies are needed.
随着最近高质量研究提供的证据越来越多，静脉铁似乎是老年髋部骨折患者输血的可靠治疗方法。本系统评价和荟萃分析旨在评估静脉铁在老年髋部骨折患者中的疗效和安全性。
从 Web of Science、PubMed、Embase 和 Scopus 中确定评估静脉铁对接受髋部骨折治疗的老年患者影响的潜在相关文献。我们使用固定效应模型和随机效应模型进行了成对荟萃分析，并使用 RevMan 5.1 进行了数据汇总。
四项随机对照试验和四项观察性研究符合纳入标准。荟萃分析结果表明，与对照组相比，静脉铁降低了输血率，但结果未达到统计学意义。静脉铁与较低的输血量、较短的住院时间和降低的医院感染风险相关。且在死亡率和其他并发症方面，治疗组与对照组之间无显著差异。
目前的证据表明，静脉铁可减少输血量、住院时间和医院感染风险。静脉铁需要大约 7 天才能使血红蛋白升高 1g/dl，大约 1 个月才能升高 2g/dl。静脉铁的安全性也令人放心，需要更多高质量的研究。
