title: The missed opportunities to diagnose and treat iron deficiency in patients hospitalized with heart failure.
abstract: BACKGROUND
  Iron Deficiency (ID) is common in heart failure (HF), and is an independent contributor to mortality and morbidity. We examined whether patients with previously known HF who were recently hospitalized, had previous treatment for ID, were investigated for it at the time of hospitalization, and, if ID was found, were prescribed iron on discharge.
  
  
  METHODS
  We examined the records of 76 consecutive patients admitted to our hospital medical wards with a primary diagnosis of HF.
  
  
  RESULTS
  Anemia (Hb<12 g/dl) was found in 42/76 patients (55.3%). In 55/76 patients (72.4%) there was no iron workup, in 6 (7.9%) an incomplete iron workup with serum iron, transferrin or ferritin lacking and in 15/76 (19.7%) a complete iron workup. If ID was defined as either a serum ferritin of <100 μg/l or a serum ferritin of 100-299 μg/l and a %Transferrin Saturation of <20% it was found in 12/15 (80%) of those with a complete workup; in 9 of 10 (90%) of the anemic patients and in 3 of 5 (60%) of those non-anemic patients. At discharge 11/15 (73.3%) of those with a complete iron workup were given iron, 10 orally and 1 IV. In those 6 with an incomplete workup 2 were started on oral iron (33.3%) and in those without any workup, 1 of 55 (1.8%) was given oral iron.
  
  
  CONCLUSIONS
  ID is common in hospitalized HF patients but is usually not sought after by physicians at the time of admission. However if detected the physicians usually treated it.
authors: Dept of Nephrology, Tel Aviv Souraski Medical Center, Tel Aviv, Israel. Electronic address: donald@netvision.net.il.
authors: Donald S
authors: DS
authors: Silverberg
authors: Doron
authors: D
authors: Schwartz
authors: Idit
authors: I
authors: Schwartz
authors: Eyal
authors: E
authors: Ben Assa
mesh_terms: D000284:Administration, Oral; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D005293:Ferritins / Q000097:blood*; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007275:Injections, Intravenous; D007297:Inpatients; D007501:Iron / Q000097:blood*; D058085:Iron Compounds / Q000008:administration & dosage*; D007557:Israel / Q000453:epidemiology; D009017:Morbidity / Q000639:trends; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014168:Transferrin / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D058085:Iron Compounds; D014168:Transferrin; D005293:Ferritins; D007501:Iron
keywords: Anemia; Heart failure; Intravenous iron; Iron deficiency; Oral iron