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Intravenous Iron Infusion as an Alternative to Blood Transfusion in Severely Anemic Gynecologic Patients [5Q]

Amrane, Selma, MD; Skupski, Benjamin; Prasad, Nishant, MD; Tsai, Tony, MD

doi: 10.1097/01.AOG.0000483564.08809.cc
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INTRODUCTION: Intravenous iron (IV) is likely under utilized for the treatment of anemia, and has numerous advantages compared to oral iron and blood transfusion. We describe our experience with IV iron infusion in severely anemic patients with gynecologic conditions.

METHODS: This is a case series of severely anemic patients who received outpatient intravenous iron therapy for gynecologic pathology between November 2012 and January 2014. The change in hemoglobin for each patient was divided by the total amount of iron infused (mg) for each patient to calculate the iron dose that produced a hemoglobin increase of 1 g/dL. Using this data, the median value of hemoglobin increase was calculated. Costs of iron therapy, costs of transfusion therapy, and reimbursements were obtained. Using cost and reimbursement data, cost savings and net revenue were calculated.

RESULTS: Thirteen patients were eligible for inclusion. There were no adverse reactions following iron infusion. The dose range of IV iron was 100–300 mg, and patients received 2–5 infusions. Total doses were 400–1300 mg. 12/13 patients had an increase in hemoglobin. The median increase in hemoglobin was 1.7 g/dL. The median dose of iron that produced an increase in hemoglobin of one point was 423.9 mg. Net revenue was $10,171.02 for these 13 patients. The number of units of blood not used for these 13 patients was 31.

CONCLUSION: IV iron therapy is a safe and effective way of increasing hemoglobin levels in severely anemic gynecologic patients, with significant cost and resource savings as compared to blood transfusion.

Weill Cornell Medical Center, New York, NY

Financial Disclosure: The authors did not report any potential conflicts of interest.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.