{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:02:20Z","timestamp":1781071340422,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preoperative iron deficiency anemia (IDA) affects 30%\u201344% of non\u2010cardiac surgical patients and is associated with poor postoperative outcomes. Few studies have examined IDA surgical patients' outcomes by sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>TriNetX Research Network was queried from 2005 to 2025. We compared adult female and male surgical patients with IDA within 1\u2009month preoperatively. Sub\u2010analyses were performed for ages 18\u201355, 56+ years, and cardiac surgical patients. We performed propensity score matching on surgical type, demographics, and comorbidities. We tracked 30\u2010day postoperative mortality, respiratory, renal, ischemic, thrombotic, infectious, and combined morbidity, RBC transfusions, and hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After matching, 418,172 IDA patients were in each cohort. Female patients had lower risk of 30\u2010day postoperative mortality than male patients (1.79% vs. 2.35%, Risk Ratio (RR): 0.76 [95% Confidence Interval: 0.74\u20130.79]), respiratory morbidity (1.25% vs. 2.16%, RR: 0.58 [0.56\u20130.60]), renal morbidity (6.00% vs. 8.67%, RR: 0.69 [0.68\u20130.70]), ischemic morbidity (3.04% vs. 3.89%, RR: 0.78 [0.76\u20130.80]), thromboembolic morbidity (2.86% vs. 3.39%, RR: 0.84 [0.82\u20130.86]), infectious morbidity (5.17% vs. 7.96%, RR: 0.65 [0.64\u20130.66]), and hemorrhage (0.18% vs. 0.24%, RR: 0.77 [0.70\u20130.85]). Sex had a lesser impact after cardiac surgery. Female sex was associated with a lower risk of infectious morbidity, combined morbidity, and renal morbidity; all other outcomes were not significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our findings underscore the importance of incorporating sex\u2010specific considerations into perioperative risk stratification, particularly in patients with preoperative anemia. Most sex differences were not present in cardiac surgery patients, suggesting potential interactions between surgical type, baseline risk, and transfusion or anticoagulation practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70190","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T04:24:19Z","timestamp":1775190259000},"page":"1070-1078","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex differences in surgical patients with preoperative iron deficiency anemia"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2406-2594","authenticated-orcid":false,"given":"Una E.","family":"Choi","sequence":"first","affiliation":[{"name":"Mass General Brigham\/Brigham and Women's Hospital, Harvard Medical School Department of Anesthesiology  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan C.","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital, Johns Hopkins University School of Medicine Department of Anesthesiology and Critical Care Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Hepner","sequence":"additional","affiliation":[{"name":"Mass General Brigham\/Brigham and Women's Hospital, Harvard Medical School Department of Anesthesiology  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean M.","family":"Connors","sequence":"additional","affiliation":[{"name":"Mass General Brigham\/Brigham and Women's Hospital, Harvard Medical School Department of Hematology  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Promise","family":"Ariyo","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital, Johns Hopkins University School of Medicine Department of Anesthesiology and Critical Care Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinead","family":"Nyhan","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital, Johns Hopkins University School of Medicine Department of Anesthesiology and Critical Care Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3533-3190","authenticated-orcid":false,"given":"Steven M.","family":"Frank","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital, Johns Hopkins University School of Medicine Department of Anesthesiology and Critical Care Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2074-8441","authenticated-orcid":false,"given":"Nadia B.","family":"Hensley","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital, Johns Hopkins University School of Medicine Department of Anesthesiology and Critical Care Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066620913262"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c4408"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2021.12.002"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14636"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000006974"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61381-0"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13840"},{"issue":"2","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2018-000901","article-title":"Prevalence and prognostic implication of iron deficiency and anaemia in patients 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