{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:26:33Z","timestamp":1784262393932,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,12,2]],"date-time":"2017-12-02T00:00:00Z","timestamp":1512172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Iron deficiency anaemia is strongly associated with poor outcomes after cardiac surgery. However, pre\u2010operative non\u2010anaemic iron deficiency (a probable anaemia precursor) has not been comprehensively examined in patients undergoing cardiac surgery, despite biological plausibility and evidence from other patient populations of negative effect on outcome. This exploratory retrospective cohort study aimed to compare an iron\u2010deficient group of patients undergoing cardiac surgery with an iron\u2010replete group. Consecutive non\u2010anaemic patients undergoing elective coronary artery bypass grafting or single valve replacement in our institution between January 2013 and December 2015 were considered for inclusion. Data from a total of 277 patients were analysed, and were categorised by iron status and blood haemoglobin concentration into iron\u2010deficient (n = 109) and iron\u2010replete (n = 168) groups. Compared with the iron\u2010replete group, patients in the iron\u2010deficient group were more likely to be female (43% vs. 12%, iron\u2010replete, respectively); older, mean (SD) age 64.4 (9.7) vs. 63.2 (10.3) years; and to have a higher pre\u2010operative EuroSCORE (median IQR [range]) 3 (2\u20135 [0\u201310]) vs. 3 (2\u20134 [0\u20139]), with a lower preoperative haemoglobin of 141.6 (11.6) vs. 148.3 (11.7) g.l\n                    <jats:sup>\u22121<\/jats:sup>\n                    . Univariate analysis suggested that iron\u2010deficient patients had a longer hospital length of stay (7 (6\u20139 [2\u201340]) vs. 7 (5\u20138 [4\u201323]) days; p = 0.013) and fewer days alive and out of hospital at postoperative day 90 (83 (80\u201384 [0\u201387]) vs. 83 (81\u201385 [34\u201386]), p = 0.009). There was no evidence of an association between iron deficiency and either lower nadir haemoglobin or higher requirement for blood products during inpatient stay. After adjusting the model for pre\u2010operative age, sex, renal function, Euro\n                    <jats:styled-content style=\"fixed-case\">SCORE<\/jats:styled-content>\n                    and haemoglobin, the mean increase in hospital length of stay in the iron\u2010deficient group relative to the iron\u2010replete group was 0.86 days (bootstrapped 95%CI \u22120.37 to 2.22, p = 0.098). This exploratory study suggests there is weak evidence of an association between non\u2010anaemic iron deficiency and outcome after cardiac surgery after controlling for potentially confounding variables.\n                  <\/jats:p>","DOI":"10.1111\/anae.14115","type":"journal-article","created":{"date-parts":[[2017,12,2]],"date-time":"2017-12-02T01:32:43Z","timestamp":1512178363000},"page":"450-458","source":"Crossref","is-referenced-by-count":47,"title":["Postoperative outcomes following cardiac surgery in non\u2010anaemic iron\u2010replete and iron\u2010deficient patients \u2013 an exploratory study"],"prefix":"10.1111","volume":"73","author":[{"given":"L. F.","family":"Miles","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Anaesthetic Peri\u2010operative and Pain Medicine Unit Melbourne School of Population and Global Health and Melbourne Clinical and Translational Science Platform (MCATS) University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. A.","family":"Kunz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Austin Health Melbourne School of Population and Global Health and Melbourne Clinical and Translational Science Platform (MCATS) University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. H.","family":"Na","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health and Melbourne Clinical and Translational Science Platform (MCATS) University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Braat","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health and Melbourne Clinical and Translational Science Platform (MCATS) University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Burbury","sequence":"additional","affiliation":[{"name":"Department of Haematology Victorian Comprehensive Cancer Centre Melbourne School of Population and Melbourne Clinical and Translational Science Platform (MCATS) University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. A.","family":"Story","sequence":"additional","affiliation":[{"name":"Anaesthetic Peri\u2010operative and Pain Medicine Unit and Melbourne Clinical and Translational Science Platform (MCATS) University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-305856"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.640"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0094217"},{"key":"e_1_2_6_5_1","first-page":"1","article-title":"Non\u2010anaemic iron deficiency \u2013 a disease looking for recognition of diagnosis: a systematic review","volume":"96","author":"Pratt JJ","year":"2015","journal-title":"European Journal of Haematology"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13773"},{"key":"e_1_2_6_7_1","unstructured":"National Blood Authority.Perioperative patient blood management guidelines: module 2.2012.http:\/\/www.blood.gov.au\/system\/files\/documents\/pbm-module-2.pdf(accessed 10\/03\/2017)."},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e32834ad97b"},{"key":"e_1_2_6_9_1","article-title":"Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity","author":"Chan M","year":"2011","journal-title":"World Health Organization"},{"key":"e_1_2_6_10_1","first-page":"58","article-title":"Iron deficiency in patients with heart failure","volume":"1","author":"Fitzsimons S","year":"2015","journal-title":"European Heart Journal"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040296"},{"key":"e_1_2_6_12_1","first-page":"164","article-title":"Review on iron and its importance for human health","volume":"19","author":"Abbaspour N","year":"2014","journal-title":"Journal of Research and Medical Science"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-199312000-00012"},{"key":"e_1_2_6_14_1","first-page":"A572","article-title":"Effect of iron treatment on adaptation to physical training in marginally iron\u2010deficient non\u2010anemic women","volume":"13","author":"Brownlie T","year":"1999","journal-title":"FASEB Journal"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.2000.88.3.1103"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/79.3.437"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/75.4.734"},{"key":"e_1_2_6_18_1","first-page":"407","article-title":"Effect of intravenous iron sucrose on exercise tolerance in anemic and non\u2010anemic patients with symptomatic chronic heart failure and iron deficiency: a randomised, controlled, observer\u2010blinded trial (FERRIC\u2010HF)","volume":"114","author":"Okonko DO","year":"2006","journal-title":"Circulation"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0908355"},{"key":"e_1_2_6_20_1","first-page":"S167","article-title":"Effect of intravenous iron sucrose on exercise tolerance in anaemic and non\u2010anaemic iron deficient patients with chronic heart failure: a randomised, controlled, observer\u2010blinded trial (FERRIC\u2010HF)","volume":"27","author":"Okonko DO","year":"2006","journal-title":"European Heart Journal"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.473"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.01.017"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2015-095505"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149881"},{"key":"e_1_2_6_25_1","first-page":"2114","article-title":"Iron Deficiency \u2013 United States, 1999\u20132000","volume":"288","author":"Centres for Disease Control","year":"2002","journal-title":"Journal of the American Medical Association"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f4822"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13423"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13840"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fanae.14115","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.14115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:31:30Z","timestamp":1761676290000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.14115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,2]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1111\/anae.14115"],"URL":"https:\/\/doi.org\/10.1111\/anae.14115","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,2]]}}}