Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN.
University of Minnesota School of Medicine, Minneapolis, MN.
Blood Adv. 2024 Dec 10;8(23):6029-6034. doi: 10.1182/bloodadvances.2024013197.
Iron deficiency (ID) is a global health problem with consequences independent of anemia, including impaired cognition and exercise tolerance. The time from laboratory diagnosis to resolution of ID has not been defined. In a retrospective review of electronic medical record data from a Minnesota statewide health system, we identified patients with ID (ferritin level ≤25 ng/mL). Patients with at least 1 follow-up ferritin level within 3 years were included. Patients with a subsequent ferritin of ≥50 ng/mL were classified as having resolved ID. Descriptive statistics and time-to-event analyses were used to determine proportion of ID resolution and time to resolution, and to evaluate characteristics predictive of resolution. We identified 13 084 patients with ID between 2010 to 2020. We found that 5485 (41.9%) had resolution within 3 years of diagnosis, whereas 7599 (58.1%) had no documented resolution. The median time to resolution was 1.9 years (interquartile range, 0.8-3.9). Factors associated with greater likelihood of resolution included age of ≥60 years (adjusted hazard ratio [aHR], 1.56; 95% confidence interval [CI], 1.44-1.69]), male sex (aHR, 1.58; 95% CI, 1.48-1.70]) and treatment with intravenous iron (aHR, 2.96; 95% CI, 2.66-3.30). Black race was associated with a lower likelihood of resolution (aHR, 0.73; 95% CI, 0.66-0.80). We observed a high proportion of persistent ID and prolonged time to resolution overall, with greater risk of lack of resolution among females and Black individuals. Targeted knowledge translation interventions are required to facilitate prompt diagnosis and definitive treatment of this prevalent and correctable condition.
缺铁症（ID）是一个全球性的健康问题，其后果独立于贫血，包括认知受损和运动耐量下降。从实验室诊断到缺铁症解决的时间尚未确定。在对明尼苏达州全州卫生系统电子病历数据的回顾性审查中，我们确定了缺铁症患者（铁蛋白水平≤25ng/mL）。至少有 1 次在 3 年内进行的铁蛋白随访结果的患者被纳入研究。随后铁蛋白≥50ng/mL 的患者被归类为缺铁症已解决。采用描述性统计和时间事件分析来确定缺铁症的解决比例和解决时间，并评估预测解决的特征。我们在 2010 年至 2020 年期间确定了 13084 名缺铁症患者。我们发现，5485 名（41.9%）患者在诊断后 3 年内得到解决，而 7599 名（58.1%）患者没有明确的解决记录。解决的中位时间为 1.9 年（四分位间距，0.8-3.9）。与更大的解决可能性相关的因素包括年龄≥60 岁（调整后的危险比[aHR]，1.56；95%置信区间[CI]，1.44-1.69））、男性（aHR，1.58；95%CI，1.48-1.70）和静脉铁治疗（aHR，2.96；95%CI，2.66-3.30）。黑种人种族与解决可能性较低相关（aHR，0.73；95%CI，0.66-0.80）。我们观察到总体上持续存在的缺铁症比例较高，且解决时间延长，女性和黑人个体的解决可能性较低。需要有针对性的知识转化干预措施，以促进这种普遍存在且可纠正的疾病的及时诊断和明确治疗。
