Ferric Carboxymaltose for Anemic Perioperative Populations: A Systematic Literature Review of Randomized Controlled Trials.
Ferric Carboxymaltose for Anemic Perioperative Populations: A Systematic Literature Review of Randomized Controlled Trials.
复制标题
DOI：
10.2147/jbm.s295041
复制
发表时间：
2021
影响因子：
2
通讯作者：
Shwarz M
中科院分区：
文献类型：
--
作者：
Jones JJ;Mundy LM;Blackman N;Shwarz M
围手术期贫血是一种常见的合并症，与择期外科手术患者发病率和死亡率增加有关。我们进行了一项系统的文献综述（SLR），以确定静脉注射三羧基麦芽糖铁（FCM）在术前、术中和术后择期手术护理中治疗围手术期贫血的有效性和安全性。符合SLR纳入标准的研究报告了在围手术期随机分配给FCM治疗围手术期贫血的成人研究人群的治疗效果。筛选后，从MEDLINE和EMBASE数据库中检索到的181项研究中有10项被纳入本综述。6项研究报道了术前治疗，1项研究报道了术中治疗，2项研究报道了术后治疗，1项研究报道了术前和术后治疗。共研究了1975例患者，其中943例随机分配到FCM组，其中914例接受FCM治疗。这10项研究报告了结肠、胃、骨科、腹部、泌尿科、整形、颈部、妇科和耳鼻喉科手术的选择性手术人群。鉴于这些研究的临床和方法学异质性，分析仅限于定性评估，没有进行meta分析。与比较组（安慰剂、口服铁、标准治疗或这些组合）相比，所有10项研究均报告了FCM治疗在血红蛋白浓度、血清铁蛋白和/或转铁蛋白饱和度方面有统计学上更大的变化。两项研究报告了输液率的统计学差异，两项研究报告了FCM与比较国之间住院时间的统计学差异。该SLR增加了现有数据，即术前和术后使用FCM可改善血液学参数。本综述中的几项研究支持FCM在减少输血率和住院时间方面的有益作用。可能需要更大规模、设计良好、更长期的研究来进一步确定FCM在择期手术围手术期贫血患者中的有效性和安全性。
Perioperative anemia is a common comorbid condition associated with increased risk of morbidity and mortality in patients undergoing elective surgical procedures. We conducted a systematic literature review (SLR) to determine the efficacy and safety of the use of intravenous ferric carboxymaltose (FCM) for the treatment of perioperative anemia in preoperative, intraoperative, and postoperative elective surgical care. Studies meeting inclusion criteria for the SLR reported on treatment efficacy in an adult study population randomly allocated to FCM for the treatment of perioperative anemia during the perioperative period. After screening, 10 of 181 identified studies from searches in MEDLINE and EMBASE databases were identified for inclusion in this review. Preoperative treatment was reported in six studies, intraoperative treatment in one study, postoperative treatment in two studies, and both pre- and postoperative treatment in one study. Together, 1975 patients were studied, of whom 943 were randomized to FCM, of whom 914 received FCM treatment. The 10 studies reported elective surgical populations for colorectal, gastric, orthopedic, abdominal, urologic, plastic, neck, gynecologic, and otolaryngologic procedures. Given the clinical and methodological heterogeneity of the studies, the analyses were limited to qualitative assessments without meta-analyses. All 10 studies reported statistically greater changes in hemoglobin concentration, serum ferritin, and/or transferrin saturation with FCM treatment compared with comparators (placebo, oral iron, standard care, or a combination of these). Two studies reported statistically significant differences in transfusion rate and 2 studies reported significant differences in length of hospital stay between FCM and its comparator(s). This SLR adds to existing data that administration of FCM in preoperative and postoperative settings improves hematologic parameters. Several studies in the review supported the beneficial effects of FCM in reducing transfusion rate and length of stay. Larger, well-designed, longer-term studies may be needed to further establish the efficacy and safety of FCM in elective surgery patients with perioperative anemia.