Prevalence and prognostic impact of anemia and iron deficiency in patients hospitalized in an internal medicine ward: The PRO-IRON study

Eur J Haematol. 2017 Dec;99(6):505-513. doi: 10.1111/ejh.12963. Epub 2017 Oct 13.

Abstract

Objectives: To assess prevalence, predictive factors, and prognostic impact on in-hospital mortality of anemia, iron deficiency anemia (IDA), iron deficiency with or without anemia (ID), and iron deficiency without anemia (IDWA) in patients admitted to an internal medicine ward.

Methods: This 1-year prospective study collected data on demographics, medical history, and blood tests in 771 consecutive patients on admission.

Results: Most patients were ≥65 years old (80%) and had hypertension (63%), moderate chronic kidney disease (CKD) (43%), and heart failure (41%). Prevalence of anemia, IDA, ID, and IDWA was 67%, 41%, 58%, and 18%, respectively. Anemia was independently associated with age ≥65 years (OR 1.76, 95% CI 1.15-2.70), active cancer (OR 2.44, 95% CI 1.42-4.39), and moderate CKD (OR 1.65, 95% CI 1.12-2.43). ID was independently associated with female gender (OR 2.29, 95% CI 1.64-3.22), heart failure (OR 1.65, 95% CI 1.16-2.37), and moderate CKD (OR 2.95, 95% CI 2.04-4.30). Incidence of in-hospital mortality was 21% and independently associated with anemia (RR 1.82, 95% CI 1.21-2.74).

Conclusions: Anemia and iron deficiency were highly prevalent in internal medicine patients. As anemia negatively impacts on in-hospital mortality, awareness should be raised for effective diagnosis and management of these comorbidities in hospitalized patients.

Keywords: anemia; internal medicine ward; iron deficiency; prevalence; prognosis; risk factors.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anemia / diagnosis
  • Anemia / epidemiology*
  • Anemia / etiology
  • Anemia, Iron-Deficiency / diagnosis
  • Anemia, Iron-Deficiency / epidemiology*
  • Anemia, Iron-Deficiency / etiology
  • Biomarkers
  • Female
  • Hospitalization*
  • Humans
  • Incidence
  • Internal Medicine*
  • Iron / blood
  • Iron / metabolism
  • Male
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Prognosis
  • Prospective Studies

Substances

  • Biomarkers
  • Iron