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Improved preoperative iron status assessment by soluble transferrin receptor in elderly patients undergoing knee and hip replacement.
Clin Lab Haematol. 2006 Dec; 28(6):370-5.CL

Abstract

A poor preoperative haemoglobin (Hb) status is frequently encountered among adult patients scheduled for corrective surgery of the locomotive system, representing the main risk factor for blood transfusion. The soluble transferrin receptor (sTfR) has become a highly specific parameter for the detection of iron deficits as it can differentiate between iron deficiency anaemia and anaemia of chronic disease, because of the lack of effect by associated inflammation, unlike ferritin. The objectives of this study were to evaluate patients with the prevalence of risk for transfusion, the effect of inflammation on ferritin (F) values and functional iron deficiency in elderly patients with advanced degenerative arthropathy scheduled for hip or knee replacement. This observational, prospective study included patients over 50 years, operated for hip or knee replacements between April and June 2004. Of 218 patients studied, 87 (39%) presented with Hb levels between 10 and 13 g/dl. The prevalence of functional iron deficit was 27% (sTfR > 1.76 mg/l), while only 8.6% of patients displayed F levels below normal. As expected, C-reactive protein levels were elevated in 24.8% of patients and erythrocyte sedimentation rate was elevated in 50%. These inflammatory markers did not correlate with levels of either F or sTfR. Multiple factors can affect F levels, such as the inflammatory status of osteoarthritis in the elderly, obesity, nonsteroidal anti-inflammatory drugs therapy and low physical performance. As sTfR is not affected by inflammation, it has emerged as a primary parameter for the evaluation of iron status during preoperative assessment among patients scheduled for arthroplasty surgery. Our data strongly suggest that sTfR measurement contributes to improve patient management.

Authors+Show Affiliations

Department of Anaesthesiology, Hospital Clinic Barcelona, Villaroel no. 170, 08036 Barcelona, Spain. mbasora@clinic.ub.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

17105489

Citation

Basora, M, et al. "Improved Preoperative Iron Status Assessment By Soluble Transferrin Receptor in Elderly Patients Undergoing Knee and Hip Replacement." Clinical and Laboratory Haematology, vol. 28, no. 6, 2006, pp. 370-5.
Basora M, Deulofeu R, Salazar F, et al. Improved preoperative iron status assessment by soluble transferrin receptor in elderly patients undergoing knee and hip replacement. Clin Lab Haematol. 2006;28(6):370-5.
Basora, M., Deulofeu, R., Salazar, F., Quinto, L., & Gomar, C. (2006). Improved preoperative iron status assessment by soluble transferrin receptor in elderly patients undergoing knee and hip replacement. Clinical and Laboratory Haematology, 28(6), 370-5.
Basora M, et al. Improved Preoperative Iron Status Assessment By Soluble Transferrin Receptor in Elderly Patients Undergoing Knee and Hip Replacement. Clin Lab Haematol. 2006;28(6):370-5. PubMed PMID: 17105489.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improved preoperative iron status assessment by soluble transferrin receptor in elderly patients undergoing knee and hip replacement. AU - Basora,M, AU - Deulofeu,R, AU - Salazar,F, AU - Quinto,L, AU - Gomar,C, PY - 2006/11/16/pubmed PY - 2007/1/17/medline PY - 2006/11/16/entrez SP - 370 EP - 5 JF - Clinical and laboratory haematology JO - Clin Lab Haematol VL - 28 IS - 6 N2 - A poor preoperative haemoglobin (Hb) status is frequently encountered among adult patients scheduled for corrective surgery of the locomotive system, representing the main risk factor for blood transfusion. The soluble transferrin receptor (sTfR) has become a highly specific parameter for the detection of iron deficits as it can differentiate between iron deficiency anaemia and anaemia of chronic disease, because of the lack of effect by associated inflammation, unlike ferritin. The objectives of this study were to evaluate patients with the prevalence of risk for transfusion, the effect of inflammation on ferritin (F) values and functional iron deficiency in elderly patients with advanced degenerative arthropathy scheduled for hip or knee replacement. This observational, prospective study included patients over 50 years, operated for hip or knee replacements between April and June 2004. Of 218 patients studied, 87 (39%) presented with Hb levels between 10 and 13 g/dl. The prevalence of functional iron deficit was 27% (sTfR > 1.76 mg/l), while only 8.6% of patients displayed F levels below normal. As expected, C-reactive protein levels were elevated in 24.8% of patients and erythrocyte sedimentation rate was elevated in 50%. These inflammatory markers did not correlate with levels of either F or sTfR. Multiple factors can affect F levels, such as the inflammatory status of osteoarthritis in the elderly, obesity, nonsteroidal anti-inflammatory drugs therapy and low physical performance. As sTfR is not affected by inflammation, it has emerged as a primary parameter for the evaluation of iron status during preoperative assessment among patients scheduled for arthroplasty surgery. Our data strongly suggest that sTfR measurement contributes to improve patient management. SN - 0141-9854 UR - https://www.unboundmedicine.com/medline/citation/17105489/Improved_preoperative_iron_status_assessment_by_soluble_transferrin_receptor_in_elderly_patients_undergoing_knee_and_hip_replacement_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0141-9854&date=2006&volume=28&issue=6&spage=370 DB - PRIME DP - Unbound Medicine ER -