{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T15:40:36Z","timestamp":1790782836549,"version":"4.1.0"},"reference-count":24,"publisher":"The Korean Society of Anesthesiologists","issue":"6","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ekja.org"],"crossmark-restriction":true},"short-container-title":["Korean J Anesthesiol"],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:p>Background: Non-anemic iron deficiency (ID) may be harmful during cardiac surgery with cardiopulmonary bypass. However, its impact on off-pump coronary artery bypass (OPCAB) remains unclear. This study examined the association between non-anemic ID and outcomes following OPCAB. Methods: This single-center retrospective study included non-anemic patients who underwent OPCAB between November 2016 and May 2023. Patients were classified by preoperative ID status, defined as serum ferritin &lt; 100 \u03bcg\/L or 100\u2013300 \u03bcg\/L with C-reactive protein &gt; 5 mg\/L or transferrin saturation &lt; 20%. The risk of primary outcome, defined as the composite of acute kidney injury, permanent stroke, deep sternal wound infection, hemostatic reoperation, prolonged mechanical ventilation, delirium, myocardial infarction, and 30-day mortality, was compared using multivariable logistic regression. Mediation analysis was performed to determine the indirect effects of non-anemic ID via perioperative red blood cell (RBC) transfusion.Results: Of the 433 non-anemic patients, 229 (52.9%) had ID. The incidence of composite outcome was similar between patients with and without ID (30.1% vs. 22.5%, P = 0.075). ID was not significantly associated with the composite outcome, whereas perioperative transfusion (odds ratio: 2.10, 95% CI [1.17\u20133.78], P = 0.013) showed significant associations. Perioperative RBC transfusion was more common in patients with ID (25.8% vs. 10.8%, P &lt; 0.001). Mediation analysis suggested that RBC transfusion partially mediated the effect of ID on the composite outcome.Conclusions: Preoperative ID was not associated with adverse outcomes in non-anemic patients who had undergone OPCAB. However, its indirect impact via RBC transfusion warrants further investigation.<\/jats:p>","DOI":"10.4097\/kja.25022","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T08:47:52Z","timestamp":1758012472000},"page":"560-568","update-policy":"https:\/\/doi.org\/10.4097\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Association between non-anemic iron deficiency and outcomes following off-pump coronary artery bypass surgery: a retrospective analysis"],"prefix":"10.4097","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9807-0757","authenticated-orcid":true,"given":"Heesoo","family":"Shin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3108-8693","authenticated-orcid":true,"given":"Hye-Bin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9093-9692","authenticated-orcid":true,"given":"Jae-Kwang","family":"Shim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7518-2070","authenticated-orcid":true,"given":"Jong Wook","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8402-5624","authenticated-orcid":true,"given":"Seo Hee","family":"Ko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2984-9927","authenticated-orcid":true,"given":"Young-Lan","family":"Kwak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2573","reference":[{"key":"ref1","first-page":"422","volume-title":"Current misconceptions in diagnosis and management of iron deficiency","author":"Mu\u00f1oz","year":"2017"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2015.06.827"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1080\/00015385.2017.1351239"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.01.017"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2019.09.016"},{"key":"ref6","volume-title":"Patient blood management guidelines: module 2 perioperative [serial on the Internet]"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13773"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1161\/circresaha.122.321667"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15681"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/s2352-3026(22)00142-9"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0000000000006822"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezae352"},{"key":"ref13","first-page":"1","volume-title":"Kidney disease: improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury","author":"Kellum","year":"2012"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.1038"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.01.053"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezs043"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa0908355"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1161\/circheartfailure.117.004519"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v059.i05"},{"key":"ref20","first-page":"214","volume-title":"Randomized clinical trial of preoperative oral versus intravenous iron in anaemic patients with colorectal cancer","author":"Keeler","year":"2017"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)31539-7"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-016-0271-5"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.113.000707"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.698977"}],"container-title":["Korean Journal of Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ekja.org\/upload\/pdf\/kja-25022.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ekja.org\/journal\/view.php?doi=10.4097\/kja.25022","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ekja.org\/upload\/pdf\/kja-25022.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:18:46Z","timestamp":1764289126000},"score":1,"resource":{"primary":{"URL":"http:\/\/ekja.org\/journal\/view.php?doi=10.4097\/kja.25022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"URL":"https:\/\/doi.org\/10.4097\/kja.25022","relation":{},"ISSN":["2005-6419","2005-7563"],"issn-type":[{"value":"2005-6419","type":"print"},{"value":"2005-7563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]},"assertion":[{"value":"2025-01-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-16","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}