高达 75% 接受结直肠癌手术的患者存在铁缺乏症。目前尚不清楚不伴有贫血的缺铁是否与术后预后较差有关。我们假设，在接受结直肠癌手术的没有贫血的成年人中，相对于铁充足的状态，缺铁会导致术后结果更差。我们进行了一项前瞻性观察性研究，招募了没有贫血的成年人（年龄≥18岁）正在澳大利亚和新西兰/新西兰的 16 家医院接受结直肠癌手术。贫血定义为男性血红蛋白浓度< 130 g.l-1，女性血红蛋白浓度< 120g.l-1。缺铁主要定义为转铁蛋白饱和度< 20%。主要终点是术后第 90 天的存活天数和在家中的天数。主要终点分析根据招募机构的手术风险进行了调整；性别;查尔森合并症指数； CR-POSSUM 分数；手术方法；以及新辅助治疗的要求。在 420 名患者中，170 名缺铁，250 名铁充足。缺铁组的中位存活天数（IQR [范围]）为 84.0 (80.7-85.9 [0-88.2]) 天，铁充足组为 83.1 (78.7-85.1 [0-88.9]) 天。 ） 天。组间中位数未经调整的差异为 0.9 (95% CI 0-1.8, p = 0.047) 天，调整后的差异为 0.9 (95% CI 0-1.80, p = 0.042) 天，有利于缺铁组。在接受结直肠癌手术的无贫血成年患者中，转铁蛋白饱和度 < 20% 所定义的缺铁与患者预后较差无关，并且似乎与术后第 90 天的存活天数和在家时间更长有关。© 2024 作者。约翰·威利出版的《麻醉》

Iron deficiency is present in up to 75% of patients presenting for colorectal cancer surgery. It is unclear whether iron deficiency without anaemia is associated with worse postoperative outcomes. We hypothesised that, in adults without anaemia undergoing surgery for colorectal cancer, iron deficiency would be associated with worse postoperative outcomes relative to an iron-replete state.We performed a prospective, observational study, recruiting adults (aged ≥ 18 y) without anaemia who were undergoing surgery for colorectal cancer in 16 hospitals across Australia and Aotearoa/New Zealand. Anaemia was defined as a haemoglobin concentration < 130 g.l-1 for men and < 120 g.l-1 for women. Iron deficiency was defined primarily as transferrin saturation < 20%. The primary endpoint was days alive and at home on postoperative day 90. The primary endpoint analysis was adjusted for surgical risk based on recruiting institution; sex; Charlson comorbidity index; CR-POSSUM score; surgical approach; and requirement for neoadjuvant therapy.Of 420 patients, 170 were iron deficient and 250 were iron replete. The median (IQR [range]) days alive and at home in the iron-deficient group was 84.0 (80.7-85.9 [0-88.2]) days and in the iron-replete group was 83.1 (78.7-85.1 [0-88.9]) days. The unadjusted difference in medians between groups was 0.9 (95%CI 0-1.8, p = 0.047) days and the adjusted difference was 0.9 (95%CI 0-1.80, p = 0.042) days, favouring the iron-deficient group.In adult patients without anaemia undergoing surgery for colorectal cancer, iron deficiency defined by transferrin saturation < 20% was not associated with worse patient outcomes and appeared to be associated with more days alive and at home on postoperative day 90.© 2024 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.