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

Cândida Fonseca1,2 | Manuel Araújo1 | Patrícia Moniz1 | Filipa Marques1,2 | Inês Araújo1,2 | Luís Costa1 | Joana Rodrigues1 | Luciana Frade1 | Arturo Botella1,2 | Susana Jesus1,2 | Ana Leitão1,2 | Luís Campos1,2

1 – Internal Medicine III Ward, Hospital de São Francisco Xavier – Centro Hospitalar de Lisboa Ocidental (CHLO), Lisboa, Portugal 2 – NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal


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

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