title: Iron deficiency anemia--bridging the knowledge and practice gap.
abstract: Despite its high prevalence, anemia often does not receive proper clinical attention, and detection, evaluation, and management of iron deficiency anemia and iron-restricted erythropoiesis can possibly be an unmet medical need. A multidisciplinary panel of clinicians with expertise in anemia management convened and reviewed recent published data on prevalence, etiology, and health implications of anemia as well as current therapeutic options and available guidelines on management of anemia across various patient populations and made recommendations on the detection, diagnostic approach, and management of anemia. The available evidence confirms that the prevalence of anemia is high across all populations, especially in hospitalized patients. Anemia is associated with worse clinical outcomes including longer length of hospital stay, diminished quality of life, and increased risk of morbidity and mortality, and it is a modifiable risk factor of allogeneic blood transfusion with its own inherent risks. Iron deficiency is usually present in anemic patients. An algorithm for detection and management of anemia was discussed, which incorporated iron study (with primary emphasis on transferrin saturation), serum creatinine and glomerular filtration rate, and vitamin B12 and folic acid measurements. Management strategies included iron therapy (oral or intravenous), erythropoiesis-stimulating agents, and referral as needed.
authors.affiliation: Department of Anesthesiology, Critical Care Medicine, Pain Management and Hyperbaric Medicine, Englewood Hospital and Medical Center, Englewood, NJ; Medicine and Surgery, Mount Sinai School of Medicine, New York, NY. Electronic address: Aryeh.shander@ehmc.com.
authors.forename: Aryeh
authors.initials: A
authors.lastname: Shander
authors.affiliation: Stanford University Medical Center, Stanford, CA.
authors.forename: Lawrence T
authors.initials: LT
authors.lastname: Goodnough
authors.affiliation: Department of Anesthesiology, Critical Care Medicine, Pain Management and Hyperbaric Medicine, Englewood Hospital and Medical Center, Englewood, NJ.
authors.forename: Mazyar
authors.initials: M
authors.lastname: Javidroozi
authors.affiliation: Division of Hematology and Oncology, Georgetown University School of Medicine, Washington, DC.
authors.forename: Michael
authors.initials: M
authors.lastname: Auerbach
authors.affiliation: Robert Wood Johnson Medical School, Division of Internal Medicine, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Carson
authors.affiliation: Department of Hematology/Oncology, Institute for Advanced Studies in Aging, Falls Church, VA.
authors.forename: William B
authors.initials: WB
authors.lastname: Ershler
authors.affiliation: aLab Services, San Diego, CA.
authors.forename: Mary
authors.initials: M
authors.lastname: Ghiglione
authors.affiliation: UCLA School of Medicine, JCCC Women's Cancer Research Program, Los Angeles, CA.
authors.forename: John
authors.initials: J
authors.lastname: Glaspy
authors.affiliation: Barnabas Health, South Plainfield, NJ.
authors.forename: Indu
authors.initials: I
authors.lastname: Lew
mesh_terms: D000465:Algorithms; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000628:therapy*; D003422:Critical Care; D004920:Erythropoiesis; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000737:chemistry; D006331:Heart Diseases / Q000150:complications; D006405:Hematology / Q000379:methods / Q000592:standards; D006801:Humans; D007501:Iron / Q000627:therapeutic use*; D008297:Male; D009369:Neoplasms / Q000150:complications; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011788:Quality of Life; D012120:Respiration Disorders / Q000150:complications; D016896:Treatment Outcome
chemical_list: D004921:Erythropoietin; D005293:Ferritins; D007501:Iron
keywords: Anemia; Anemia, iron-deficiency; Blood transfusion; Hemoglobin; Iron