Current problems in cardiology · 2026
Implementation of iron deficiency screening and treatment before cardiac surgery among cardiologists: determinants from a prespecified sub-analysis of the Interamerican Society of Cardiology survey.
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Perea Joaquin, Sosa-Liprandi María Inés, Villarreal Ricardo, Contreras Johanna, Quintana Miguel A, Heredia-Villacreses Fausto, Reyes Roberto Martín, Chacón-Diaz Manuel, Chango Diego X, Cueva-Torres Franklin, Olivares-Prado Francisco, Morejón-Barragán Paola, Gómez-Mesa Juan Esteban, Márquez-Murillo Manlio F, Lopez-Santi Ricardo, Ullauri Vladimir E, Baranchuk Adrián, Garcia-Zamora Sebastián
Аннотация
BACKGROUND: Iron deficiency is common in patients undergoing cardiac surgery and is associated with adverse perioperative outcomes. However, its systematic assessment and treatment remain inconsistently implemented in clinical practice.
METHODS: We performed a prespecified sub-analysis of a multinational electronic survey conducted by the Interamerican Society of Cardiology between January and August 2025. The analysis included 551 cardiologists and evaluated perceived relevance, self-reported clinical practices, and professional and institutional factors associated with the implementation of routine preoperative iron deficiency screening and frequent intravenous iron use. Two multivariable logistic regression models were constructed to identify independent determinants of implementation.
RESULTS: The median age of respondents was 41 years, and 62% were male. Although 87% considered preoperative iron deficiency management highly relevant, only 48% reported routine iron status assessment and 41% reported frequent intravenous iron use. Institutional protocols were independently associated with routine iron deficiency screening (OR 2.59, 95% CI 1.60-4.23), whereas fewer than five years of professional experience and practice at high-volume surgical centers were associated with lower odds of routine screening. Frequent intravenous iron use was independently associated with routine iron deficiency screening (OR 3.49, 95% CI 2.22-5.54), routine access to intravenous iron (OR 2.48, 95% CI 1.56-3.99), and institutional protocols (OR 2.06, 95% CI 1.26-3.40).
CONCLUSIONS: Despite high perceived clinical relevance, substantial gaps persist in the implementation of iron deficiency management before cardiac surgery. Institutional protocols, systematic screening, and access to intravenous iron appear to be key determinants of clinical adoption.
METHODS: We performed a prespecified sub-analysis of a multinational electronic survey conducted by the Interamerican Society of Cardiology between January and August 2025. The analysis included 551 cardiologists and evaluated perceived relevance, self-reported clinical practices, and professional and institutional factors associated with the implementation of routine preoperative iron deficiency screening and frequent intravenous iron use. Two multivariable logistic regression models were constructed to identify independent determinants of implementation.
RESULTS: The median age of respondents was 41 years, and 62% were male. Although 87% considered preoperative iron deficiency management highly relevant, only 48% reported routine iron status assessment and 41% reported frequent intravenous iron use. Institutional protocols were independently associated with routine iron deficiency screening (OR 2.59, 95% CI 1.60-4.23), whereas fewer than five years of professional experience and practice at high-volume surgical centers were associated with lower odds of routine screening. Frequent intravenous iron use was independently associated with routine iron deficiency screening (OR 3.49, 95% CI 2.22-5.54), routine access to intravenous iron (OR 2.48, 95% CI 1.56-3.99), and institutional protocols (OR 2.06, 95% CI 1.26-3.40).
CONCLUSIONS: Despite high perceived clinical relevance, substantial gaps persist in the implementation of iron deficiency management before cardiac surgery. Institutional protocols, systematic screening, and access to intravenous iron appear to be key determinants of clinical adoption.