Iron deficiency anaemia overview

Iron deficiency anaemia (IDA) is a common problem in primary care. It is often present in hospitalised patients, but is generally not the primary reason for admission, so may go unnoticed.

IDA occurs at all stages of life, but is most prevalent among at risk groups due to physiological, nutritional or social factors.

IDA may be an indication of an important underlying disorder, eg asymptomatic gastrointestinal (GI) cancer.

Iron deficiency and IDA have a number of clinical consequences such as fatigue, impaired cognitive function and adverse pregnancy outcomes.

Preoperative anaemia is associated with an increased likelihood of blood transfusion and subsequent increased risk of peri-operative morbidity, mortality and longer hospital stays.

Management involves two concurrent components: iron therapy to normalise the haemoglobin and replenish iron stores, and determination and treatment of the underlying cause.

Sub-optimal identification, investigation and management of IDA can lead to unnecessary and reflex decisions to transfuse. In compensated patients who do not require an immediate increase in oxygen carrying capacity, transfusion carries unnecessary risks and fails to replenish deficient iron stores. If transfusion is required (eg, for cardiac compromise or in the setting of serious acute blood loss) iron therapy should always follow to replenish iron stores.

Improving the management of IDA is important to ensure optimal health outcomes for patients and effective use of healthcare resources.

Iron therapies are effective at addressing both the haematological and non-haematological consequences of iron deficiency (such as impaired physical and cognitive function).

The cost of blood components and products is largely hidden but consumes more than $600 million every year in
Australia. This does not include the cost of the transfusion process or complications.

We have an ethical responsibility to blood donors to ensure the best use of their precious gifts and a need to ensure sufficiency of a limited resource.

Effective strategies to improve the management of iron deficiency will reduce the burden of anaemia, which will increase with our ageing population.

 

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