Authors: Tawfiq Almezeiny

Abstract

Background: Iron deficiency anemia (IDA) is frequently identified in hemodynamically stable patients and may be managed variably, including potentially avoidable transfusion. Whether intravenous (IV) iron produces similar hemoglobin (Hb) responses across anemia severity remains unclear.
Methods: We conducted a retrospective observational study of adults (≥18 years old) with IDA who were hemodynamically stable, considered asymptomatic, and who electively received IV ferric carboxymaltose in the hospital IV unit from January 1, 2022, through the end of June 2022. IDA was defined as Hb ≤ 12 g/dl with baseline serum iron ≤75 µg/dl. We excluded patients with cardiac disease, renal disease, fainting episodes, pregnancy, missing results, or loss to follow-up. Patients were grouped by baseline Hb: Group 1 (Hb 5-9 g/dl) and Group 2 (Hb 9.1-12 g/dl). We compared baseline and 1-month follow-up Hb and serum iron and calculated the final augmentation magnitude of Hb (FAM) and serum iron augmentation (IA).
Results: The final cohort included 296 patients (Group 1, n = 52; Group 2, n = 244). Hb increased in most patients in both groups. Mean FAM was higher in Group 1 than in Group 2 (3.34 vs. 1.37 g/dl; p < 0.05). Mean IA was also higher in Group 1 than in Group 2 (204 vs. 137.8 µg/dl; p < 0.05). No major adverse events (AEs) occurred; 16 patients (6.5%) experienced mild AEs. No patient received a transfusion during follow-up.
Conclusion: IV iron therapy was effective and well tolerated across Hb strata, with significantly greater Hb augmentation among patients with more severe anemia.

Keywords: Anemia, iron deficiency, serum iron, iron therapy, transfusion.