Table 1: Characteristics of included randomized controlled trials involving ESA with iron vis-a-vis iron. |
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Study |
Total number of participants |
Preoperative hemoglobin |
Surgery |
Intervention |
Comparator |
Pre or postoperative administration |
Measured outcomes |
Wu, 2016 |
62 |
Male: 13-15 Female: 12-15 |
Primary total bilateral hip replacement |
EPO (70,000 IU) (n = 30) |
Oral iron (n = 32) |
Both pre and postoperative |
1. Hemoglobin concentration 2. Reticulocyte count 3. Hematocrit 4. RBC transfusion rate 5. Deep vein thrombosis 6. Pulmonary embolism 7. Blood loss |
Stowell, 2009 |
680 |
10 to 13 |
Spine surgery |
EPO (168,000 IU) (n = 340) |
Oral iron (n = 340) |
Preoperative |
1. Deep vein thrombosis and other thrombovascular events |
Weber, 2005 |
695 |
10-13 |
Elective orthopedic procedure (spine, hip and knee) |
EPO (168,000 IU) (n = 460) |
Oral iron (n = 235) |
|
1. Number of red blood cell transfusions 2. Hemoglobin 3. Thrombotic events |
Wurnig, 2001 |
|
|
|
|
|
|
1. Number of red blood cell transfusions 2. Mortality 3. Thrombovascular events 4. Hemoglobin 5. Iron studies (serum ferritin, serum iron) |
Feagan, 2000 |
201 |
9.8 to 13.7 |
Total hip joint replacement |
EPO (80,000 IU) with oral iron (n = 44) |
Placebo with oral iron (n = 78) |
Preoperative |
1. Number of red blood cell transfusions 2. Reticulocyte count 3. Thrombovascular events |
De Andrade, 1996 |
290 |
< 15 |
Major o rthopedic surgery |
EPO (105,000 IU) with oral iron (n = 101) EPO (315,000 IU) with oral iron (n = 112) |
Placebo with oral iron (n = 103) |
Pre and postoperative |
1. Blood loss 2. Transfusions 3. Thrombovascular events 4. Adverse events (nausea, vomiting, pyrexia) |
Faris, 1996 |
185 |
No haemoglobin criteria |
Major orthopedic surgery |
EPO (105,000 IU) with oral iron (n = 71) EPO (315,000 IU) with oral iron (n = 69) |
Placebo with oral iron (n = 10) |
Pre- and postoperative |
1. Transfusion 2. Reticulocyte count 3. Hemoglobin 4. Chest pain 5. Depression |
COPES, 1993 |
208 |
11-16 |
Total hip replacement |
EPO (189,000 IU) with oral iron (n = 53) EPO (294,000 IU) with oral iron (n = 77) |
Oral iron (n = 78) |
Pre and postoperative |
1. Transfusion intraoperatively and postoperatively 2. Reticulocyte count 3. Hemoglobin 4. Length of hospital stay 5. Deep vein thrombosis |