Improved patient blood management and cost saving in hip replacement surgery through the implementation of pre-operative Sucrosomial® iron supplementation: a quality improvement assessment study

Int Orthop. 2019 Jan;43(1):39-46. doi: 10.1007/s00264-018-4149-7. Epub 2018 Sep 20.


Purpose: To compare post-operative recovery of prosthetic hip surgery patients with or without the implementation of iron supplementation with a new highly absorbable oral iron formulation.

Methods: Observational retrospective quality improvement assessment conducted on patients who had undergone elective prosthetic hip surgery (first implant) with ferritin < 100 mcg/dl and Hb values between 13 and 14 g/dl for men and 12 g/dl and 13.5 g/dl for women, or having ferritin levels > 100 mcg/dl but C-reactive protein (CRP) > 3 mg/l and transferrin saturation (TSAT) < 20%, which together are suggestive of functional iron deficiency. The analysis compared a group of non-anaemic patients having ferritin levels > 100 mcg/l to two groups of patients with iron deficiency, of which only one received iron supplementation. Measurements included haemoglobin levels, length of hospital stay, and number of transfused patients/blood units.

Results: Patients with iron deficiency supplemented with Sideral® Forte compared to non-supplemented patients showed a smaller decline in post-operative Hb (9.7 ± 1.24 g/dl vs 8.4 ± 0.6 g/dl), required shorter hospital stay (4 vs 6.5 days) and less blood transfusions (0 in the iron-supplemented group vs 7 units in the non-iron-supplemented group), yielding an overall savings of 1763.25 €/patient.

Conclusions: Pre-operative sucrosomial iron supplementation at least 4 weeks prior to elective surgery in non-anaemic patients limits the drop in post-operative Hb levels, determining higher post-operative haemoglobin, quicker post-surgical recovery, shorter hospitalisation, and decreased surgery-related costs.

Keywords: Oral sucrosomial iron; Patient blood management; Peri-operatory haemoglobin levels; Prosthetic hip surgery; Sideral® Forte.

MeSH terms

  • Arthroplasty, Replacement, Hip* / economics
  • Arthroplasty, Replacement, Hip* / methods
  • Blood Transfusion* / economics
  • Cost Savings
  • Dietary Supplements / economics
  • Elective Surgical Procedures / economics
  • Elective Surgical Procedures / methods
  • Female
  • Humans
  • Iron / administration & dosage*
  • Iron / economics
  • Male
  • Middle Aged
  • Quality Improvement
  • Retrospective Studies


  • Iron