2629 IV Iron in the Setting of Value-Based Care: Quality-of-Life Improvement and Perioperative Optimization of Anemia in The Gynecologic Population
Saeed H, Mahmood S, Girgis M, Shukr G, Kuriakose P, and Sangha R. 2629 IV Iron in the Setting of Value-Based Care: Quality-of-Life Improvement and Perioperative Optimization of Anemia in The Gynecologic Population. J Minim Invasive Gynecol 2019; 26(7):S146-S147.
J Minim Invasive Gynecol
Study Objective: To study the improvement of quality-of-life measures and hematologic response to intravenous iron in patients with chronic blood anemia undergoing gynecologic surgery Design: Prospective observational study was performed with 31 patients with hemoglobin level less than 11 g/dL and/or ferritin less than 200ug/L. Our primary outcome was to assess hematologic response (hemoglobin and iron studies) and quality of life (Health-Related Quality of Life (HRQOL) and 36-Item Short Form Survey (SF-30) questionnaires) at 30 days and 90 days. Exclusion criteria included severe hepatic impairment, malignancy or hypersensitivity to parental iron. Setting: Iron deficiency anemia is a common occurrence in women of reproductive age, especially due to blood loss from menstrual bleeding. These women frequently require gynecological surgery. However, their anemia is not frequently optimized preoperatively at the time of presentation due to poor tolerance of oral iron supplementation. Anemia increases risk of perioperative morbidity such need for blood transfusion and poor wound healing. Intravenous iron is an underutilized entity that can be used to prevent such complications with excellent patient compliance. Patients or Participants: Women with chronic blood loss anemia undergoing gynecologic surgery Interventions: Intravenous iron dextran at a fixed dose of 1000 mg following a test dose Measurements and Main Results: For hematologic response, we noted a significant improvement in hemoglobin and ferritin at 30 and 90 days. The quality-of-life scores correlated with an upward trend in T-score for physical health and mental health. An adverse reaction was noted in one patient. Conclusion: Intravenous iron is an effective low cost treatment of chronic blood loss anemia in patients who do not tolerate oral iron. In today's world of value-based care, it is imperative to use safe, cost effective and convenient interventions to optimize patients’ quality of life.