Iron Deficiency Often Missed: Delays in Diagnosis

TOPLINE: 

In a Minnesota health system, 58% of cases of iron deficiency remained unresolved after 3 years. The median time to resolution was nearly 2 years, with older age, male sex, and intravenous iron treatment associated with higher resolution rates.

METHODOLOGY:

• Researchers conducted a retrospective review of electronic medical records from the M Health Fairview system in Minnesota.
• A little over 13,000 patients with iron deficiency, which was defined as having ferritin levels
• Patients with at least one follow-up ferritin level within 3 years were included, with resolution defined as a subsequent ferritin > 50 ng/mL.
• Factors associated with resolution, such as age, sex, race/ethnicity, insurance, and treatment type, were evaluated using multivariable Cox proportional hazard regression modeling.

TAKEAWAY:

• 41.9% of patients achieved iron deficiency resolution within 3 years; the median time to resolution was nearly 2 years.
• Patients older than 60 years, who were male, and received intravenous iron treatment were more likely to achieve resolution of their iron deficiency resolution.
• Black race was associated with a lower likelihood of iron deficiency resolution compared with White race (0.73; 95% CI, 0.66-0.80; P
• Researchers concluded that clinicians need to be more aware of nonanemic iron deficiency and diagnostic ferritin levels among female and Black patients. 

IN PRACTICE:

“A wide variety of providers – from primary care providers to general surgeons – must be able to suspect and diagnose iron deficiency,” study authors wrote. “However, up to 1 in 4 providers misinterpret laboratory assessments of iron stores, and lack of awareness of the symptoms of non-anemic iron deficiency may lead providers to not offer treatment in the absence of anemia. This may result in large numbers of untreated patients with symptomatic NAID, reducing quality of life and leading to increased healthcare utilization.”

SOURCE:

The study was led by Jacob Cogan, MD, of the University of Minnesota in Minneapolis and was published online in Blood Advances.

LIMITATIONS: 

The lack of a standard test for ferratin after treatment may have affected the accuracy of the time to resolution estimate. The study’s reliance on ferritin alone, without including other iron parameters like transferrin saturation, may lead to misclassification of iron deficiency status.

DISCLOSURES: 

Various authors disclosed receiving research funding and honoraria from Octapharma, CSL Behring, and Pfizer.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.