{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T21:48:20Z","timestamp":1781819300589,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T00:00:00Z","timestamp":1667001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020211","name":"Austin Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020211","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001236","name":"Medical Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001236","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012128","name":"Austin Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012128","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006484","name":"Vifor Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Preoperative absolute and functional iron deficiency anaemia is associated with poor postoperative outcomes in patients undergoing surgery for colorectal cancer. It is biologically plausible that \u201cearly\u201d, or \u201cnonanaemic\u201d iron deficiency may also be associated with worse postoperative outcomes in similar cohorts, albeit at lesser severity than that seen for anaemia. The evidence supporting this assertion is of low quality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We have designed a prospective, observational study to delineate associations between preoperative non\u2010anaemic iron deficiency and postoperative outcomes after surgery for colorectal cancer. Patients without anaemia, undergoing elective surgery for colorectal cancer will be allocated to an iron replete or an iron deficient group based on preoperative transferrin saturation. The primary outcome is days alive and at home on postoperative day 90. Secondary outcomes include days alive and at home on postoperative day 30, length of hospital stay, readmission to acute care, postoperative complications, health\u2010related quality of life scores, quality of postoperative recovery, and requirement for allogeneic blood transfusion. The planned sample size is 422 patients, which has 80% power to detect a two\u2010day difference in the primary outcome. The study commenced in May 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of this study will provide patients and clinicians with high\u2010quality evidence concerning associations between nonanaemic iron deficiency and patient\u2010centred outcomes after surgery for colorectal cancer. The study will be conducted in multiple urban and rural centres across Australia and New Zealand. The results will be highly generalisable to contemporary surgical practice and should be rapidly translated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16371","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T06:43:20Z","timestamp":1665729800000},"page":"315-325","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A protocol for a prospective, multicentre observational study to determine if nonanaemic iron deficiency worsens postoperative outcome in patients undergoing elective surgery for resection of colorectal cancer: The <scp>NATO<\/scp> study"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2044-5560","authenticated-orcid":false,"given":"Lachlan F.","family":"Miles","sequence":"first","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School The University of Melbourne  Melbourne Australia"},{"name":"Department of Anaesthesia Austin Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Pac Soo","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health, The University of Melbourne  Melbourne Australia"},{"name":"MISCH (Methods and Implementation Support for Clinical and Health) research Hub Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Braat","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health, The University of Melbourne  Melbourne Australia"},{"name":"MISCH (Methods and Implementation Support for Clinical and Health) research Hub Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Burgess","sequence":"additional","affiliation":[{"name":"Department of Surgery, Melbourne Medical School The University of Melbourne  Melbourne Australia"},{"name":"Colorectal Surgical Unit Austin Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Heritier","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventative Medicine Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Smart","sequence":"additional","affiliation":[{"name":"Department of Surgery, Melbourne Medical School The University of Melbourne  Melbourne Australia"},{"name":"Colorectal Surgical Unit Austin Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School The University of Melbourne  Melbourne Australia"},{"name":"Critical Care Institute Epworth HealthCare  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3120-9707","authenticated-orcid":false,"given":"Anna","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate L.","family":"Burbury","sequence":"additional","affiliation":[{"name":"Sir Peter MacCallum Department of Oncology Melbourne Medical School, The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Story","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School The University of Melbourne  Melbourne Australia"},{"name":"Department of Anaesthesia Austin Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the ANZCA Clinical Trials Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2005.00789.x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-017-2898-1"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/547914"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61381-0"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2017.1394833"},{"key":"e_1_2_12_7_1","unstructured":"National Blood AuthorityPerioperative Patient Blood Management Guidelines: Module 2 [Internet]2012; Available fromhttp:\/\/www.blood.gov.au\/system\/files\/documents\/pbm\u2010module\u20102.pdf"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13773"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X19838899"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50618"},{"key":"e_1_2_12_11_1","unstructured":"World Health Organization (WHO).Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and mineral nutrition information System.2011(WHO\/NMH\/NHD\/MNM\/11.1) [cited 2022 Jul 1]. Available from:http:\/\/www.who.int\/vmnis\/indicators\/haemoglobin.pdf"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2019.04.041"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102017\u2010015828"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15623"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000586"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318289b84b"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040296"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4430"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.2307\/1913643"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.101052"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-017-0442-1"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt118"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i8.1972"},{"issue":"12","key":"e_1_2_12_26_1","first-page":"CD013084","article-title":"Intravenous iron therapy for non\u2010anaemic iron deficient adults","volume":"12","author":"Miles LF","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"e_1_2_12_27_1","first-page":"CD005033","article-title":"Perioperative blood transfusions for the recurrence of colorectal cancer","volume":"2006","author":"Amato A","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"e_1_2_12_28_1","first-page":"CD005033","article-title":"Perioperative blood transfusions and recurrence of colorectal cancer","volume":"2006","author":"Amato A","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2013.10.001"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318271cedf"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.09.013"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex205"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.16371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.16371","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.16371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T08:52:25Z","timestamp":1692348745000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.16371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,29]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1111\/codi.16371"],"URL":"https:\/\/doi.org\/10.1111\/codi.16371","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,29]]},"assertion":[{"value":"2022-07-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}