Intravenous Iron Isomaltoside 1000 Reduces Postoperative Anemia in Patients Undergoing Elective Urologic Surgery and Those with Urosepsis

Hyeok Jun Goh,1 Ki Soo Lee,1 Tae Hyo Kim,1 Kyu Nam Kim,2 Hyun Jin Lim,2 Kyu Shik Kim,3 Won Jae Yang,4 Jung Ki Jo3 1Department of Urology, Dong-A University, College of Medicine, Busan, Korea; 2Department of Anesthesia and Pain Medicine, Hanyang University, College of Medicine, Seoul, Korea; 3Department of Urology, Hanyang University, College of Medicine, Seoul, Korea; 4Department of Urology, Soonchunghyang University Hospital, Seoul, KoreaCorrespondence: Jung Ki JoDepartment of Urology, Hanyang University, College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, KoreaTel +821025196241Email victorjo38@hanyang.ac.krPurpose: Postoperative anemia is associated with increased morbidity and mortality in patients undergoing surgery. Anemia is also a common feature during sepsis. Therefore, here, we aimed to investigate the safety and efficacy of intravenous iron isomaltoside 1000 (Monofer®) in patients undergoing elective urologic surgery and in those with urosepsis.Materials and Methods: This multicenter study was conducted through the review of the medical records of patients with postoperative anemia undergoing elective urologic surgery or with urosepsis in a multicenter hospital. Patients received a single intravenous iron isomaltoside (IIM), and their hemoglobin (Hb) level was evaluated before and after administration of IIM. Safety data included adverse effects and hypersensitivity reactions. In addition, the patients were divided into three groups (200 mg, 400 mg, and 600 mg IIM) to compare Hb changes before and after the administration of IIM.Results: The study analyzed 52 men and 30 women with a mean age of 67 years. There was a significant difference between pre-treatment Hb and post-treatment Hb according to the type of the surgery after administration (p=0.01) of IIM in patients with postoperative anemia, and the mean preoperative Hb before IIM administration was 8.5 g/dL and that after IIM administration was 9.9 g/dL (p=0.006) in patients with urosepsis. The mean preoperative Hb changed from 10 g/dL to 11 g/dL after administration (p< 0.001) of IIM in the whole cohort. There were no side effects due to the administration of intravenous IIM.Conclusion: A single perioperative intravenous injection of IIM 1000 significantly increased the Hb level in patients with anemia who underwent urologic elective surgery. Moreover, this treatment can be considered to have potential clinical benefits for anemia caused by sepsis.Keywords: anemia, iron, iron isomaltoside 1000, urosepsis