PDF(Pubmed)
Abstract：
Abnormal uterine bleeding (AUB), which includes heavy menstrual bleeding (HMB), is a common condition placing women at increased risk for developing iron deficiency and iron deficiency anemia (IDA). Depletion of iron stores has negative implications on physical, social, and emotional health, as well as quality of life. Iron supplements are safe, effective, and readily available, while red blood cell (RBC) transfusions have inherent risks including infectious and immune reactions. Despite high prevalence of IDA among women with AUB, there are limited studies on the impact of iron therapies on patient outcomes. This systematic review and meta-analysis will evaluate the impact of iron supplementation on patient outcomes for women with AUB, when compared to combination therapy, no intervention, placebo, or standard of care.
We will conduct a systematic review and meta-analysis of randomized controlled trials and observational studies evaluating the impact of iron interventions on patient outcomes for women with AUB. Systematic literature searches will be conducted in major databases including MEDLINE, EMBASE, CENTRAL, CINAHL, and Web of Science. Studies assessing the impact of iron interventions on patient outcomes in women experiencing AUB, in comparison to combination therapy, no intervention, placebo, or standard of care, will be included in the review. Independent reviewers will screen for eligibility, assess risk of bias, and abstract data. Overall certainty of evidence for each outcome will be assessed using the GRADE approach. We will meta-analyze outcomes which are sufficiently homogeneous to summarize intervention effects and narratively synthesize nonhomogeneous outcomes. The main outcomes of interest are hemoglobin levels immediately prior to surgery and post-operatively, number of RBC transfusions, and adverse effects. Secondary outcomes will include length of hospital stay, intraoperative blood loss, adverse and side effects, quality of life, and iron indices.
This review will evaluate the impact of iron interventions on patient outcomes in women with IDA secondary to AUB with focus on changes in hematological and iron indices, red blood cell utilization, quality of life, cost of treatment, and adverse events. The results will inform evidence-based clinical practice for the management of iron deficiency and IDA secondary to AUB.
PROSPERO CRD42019137282.
We will conduct a systematic review and meta-analysis of randomized controlled trials and observational studies evaluating the impact of iron interventions on patient outcomes for women with AUB. Systematic literature searches will be conducted in major databases including MEDLINE, EMBASE, CENTRAL, CINAHL, and Web of Science. Studies assessing the impact of iron interventions on patient outcomes in women experiencing AUB, in comparison to combination therapy, no intervention, placebo, or standard of care, will be included in the review. Independent reviewers will screen for eligibility, assess risk of bias, and abstract data. Overall certainty of evidence for each outcome will be assessed using the GRADE approach. We will meta-analyze outcomes which are sufficiently homogeneous to summarize intervention effects and narratively synthesize nonhomogeneous outcomes. The main outcomes of interest are hemoglobin levels immediately prior to surgery and post-operatively, number of RBC transfusions, and adverse effects. Secondary outcomes will include length of hospital stay, intraoperative blood loss, adverse and side effects, quality of life, and iron indices.
This review will evaluate the impact of iron interventions on patient outcomes in women with IDA secondary to AUB with focus on changes in hematological and iron indices, red blood cell utilization, quality of life, cost of treatment, and adverse events. The results will inform evidence-based clinical practice for the management of iron deficiency and IDA secondary to AUB.
PROSPERO CRD42019137282.
摘要：
背景：异常子宫出血（AUB），其中包括大量月经出血（HMB），是一种常见的疾病，使女性患缺铁和缺铁性贫血（IDA）的风险增加。铁库的枯竭对实物有负面影响，社会,和情绪健康，以及生活质量。铁补充剂是安全的,有效,并且随时可用，而红细胞（RBC）输血具有固有风险，包括感染和免疫反应。尽管IDA在AUB女性中患病率很高，关于铁疗法对患者预后影响的研究有限.这项系统评价和荟萃分析将评估铁补充剂对AUB女性患者预后的影响。与联合治疗相比，没有干预,安慰剂,或护理标准。
方法：我们将对随机对照试验和观察性研究进行系统评价和荟萃分析，评估铁干预对AUB女性患者预后的影响。系统的文献检索将在包括MEDLINE在内的主要数据库中进行，EMBASE,中部,CINAHL,和WebofScience。评估铁干预对经历AUB的女性患者预后影响的研究，与联合治疗相比，没有干预,安慰剂,或护理标准，将包括在审查中。独立审稿人将筛选资格，评估偏见的风险，抽象数据。将使用等级方法评估每个结果的证据的总体确定性。我们将对足够同质的结果进行荟萃分析，以总结干预效果并叙述综合非同质结果。感兴趣的主要结果是手术前和手术后的血红蛋白水平，红细胞输血次数,和不利影响。次要结果将包括住院时间，术中失血,不良和副作用，生活质量,和铁指数。
结论：本综述将评估铁干预措施对AUB继发IDA女性患者预后的影响，重点关注血液学和铁指标的变化，红细胞利用率,生活质量,治疗费用,和不良事件。该结果将为基于证据的临床实践提供指导，以治疗AUB继发的铁缺乏和IDA。
背景：PROSPEROCRD42011137282。
方法：我们将对随机对照试验和观察性研究进行系统评价和荟萃分析，评估铁干预对AUB女性患者预后的影响。系统的文献检索将在包括MEDLINE在内的主要数据库中进行，EMBASE,中部,CINAHL,和WebofScience。评估铁干预对经历AUB的女性患者预后影响的研究，与联合治疗相比，没有干预,安慰剂,或护理标准，将包括在审查中。独立审稿人将筛选资格，评估偏见的风险，抽象数据。将使用等级方法评估每个结果的证据的总体确定性。我们将对足够同质的结果进行荟萃分析，以总结干预效果并叙述综合非同质结果。感兴趣的主要结果是手术前和手术后的血红蛋白水平，红细胞输血次数,和不利影响。次要结果将包括住院时间，术中失血,不良和副作用，生活质量,和铁指数。
结论：本综述将评估铁干预措施对AUB继发IDA女性患者预后的影响，重点关注血液学和铁指标的变化，红细胞利用率,生活质量,治疗费用,和不良事件。该结果将为基于证据的临床实践提供指导，以治疗AUB继发的铁缺乏和IDA。
背景：PROSPEROCRD42011137282。
