Iron supplementation for anemia after hip fracture surgery: a randomized trial of 300 patients

Anemia as a consequence of surgery is often treated with iron therapy. The evidence base for this practice is limited. To determine if oral iron therapy is beneficial for the treatment of anemia after surgery for the treatment of a hip fracture, we undertook a prospective, randomized controlled trial.

Three hundred patients with a hemoglobin level of <110 g/L after treatment for a hip fracture were randomized to receive either a twenty-eight-day course of ferrous sulfate therapy or no iron therapy. Hemoglobin levels were measured at six weeks after surgery. The length of the hospital stay and the mortality rate at one year were compared between groups.

The mean rise in hemoglobin levels six weeks after discharge from the hospital was 21 g/L in the iron group, compared with 18 g/L in the no-iron group (p = 0.07). There was no significant difference between the two groups with regard to the length of hospital stay or the mortality rate. Seventeen percent of the patients who were allocated to iron therapy reported adverse effects of the medication.

The present study demonstrated that iron therapy had no clinically relevant benefit when used to treat anemia associated with a hip fracture.