Estimating the prevalence of preoperative iron deficiency and its impact on red blood cell transfusion in adolescents undergoing scoliosis surgery: A pilot study

Abstract

Background: Iron deficiency (ID) is the leading cause of anemia, contributes to reduced physical and cognitive performance, and increases the likelihood of red blood cell (RBC) transfusion in surgical patients. Adolescents undergoing scoliosis surgery are not routinely screened for ID, though they are at heightened risk of anemia and other adverse effects. Study Design and Method: Patients aged 11–18 years undergoing scoliosis surgery from September 2021 through August 2023 at our institution were approached for participation in a pilot study examining iron and hematologic parameters from the preoperative period through surgical recovery and their association with RBC transfusion. Results: Clinical and laboratory data were obtained from a convenience sample of 46 adolescents (33 females, 13 males), of whom 17.4% (8/46) were anemic and 33.3% (14/42) were iron deficient. ID was more common in female patients (p =.017). RBC transfusions were given in 10.9% (5/46) of patients, more often in those with ID than without (28.6% vs. 3.6%, respectively, p =.018). At a clinic visit several weeks after surgery, 50% (12/24) of patients tested were anemic, while 74% (17/23) had low iron stores. Conclusions: Findings from this pilot study suggest that ID is present in over 30% of adolescents undergoing scoliosis surgery and is associated with a greater likelihood of receiving an RBC transfusion, while most patients had low iron stores during surgical recovery. Larger studies are needed to confirm the extent to which preoperative ID impacts the likelihood of RBC transfusion and to evaluate the benefit of iron supplementation.