Observational studyCritical care (London, England)2014
Prevalence of iron deficiency on ICU discharge and its relation with fatigue: a multicenter prospective study.
Observational study in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- The use of iron after surgery: a systematic review and meta-analysis.Anaesthesia · 2025Pooled it
- Mechanical ventilation in patients with acute brain injury: a systematic review with meta-analysis.Critical care (London, England) · 2023Pooled it
- Benefits of pre-operative oral Sucrosomial® iron supplementation in cardiac surgery: influence of patient's baseline hemoglobin and gender.Blood transfusion = Trasfusione del sangue · 2023Trial
- Micronutrients and ICU-Acquired Weakness: A Narrative Review.Journal of clinical medicine · 2026Review
- Intravenous Sodium Ferric Gluconate Complex for Hospitalized Pediatric Patients with Iron Deficiency Anemia.Children (Basel, Switzerland) · 2025Article
- Iron Metabolism in the Recovery Phase of Critical Illness with a Focus on Sepsis.International journal of molecular sciences · 2024Review
- Iron and erythropoietin to heal and recover after intensive care (ITHRIVE): A pilot randomised clinical trial.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2023Article
- Article
- The Limits of Acute Anemia.Journal of clinical medicine · 2022Review
- Instruments to measure outcomes of post-intensive care syndrome in outpatient care settings - Results of an expert consensus and feasibility field test.Journal of the Intensive Care Society · 2021Article
- Iron Deficiency without Anemia Decreases Physical Endurance and Mitochondrial Complex I Activity of Oxidative Skeletal Muscle in the Mouse.Nutrients · 2021Article
- Iron deficiency, fatigue and muscle strength and function in older hospitalized patients.European journal of clinical nutrition · 2021Observational
- Iron in the General Population and Specificities in Older Adults: Metabolism, Causes and Consequences of Decrease or Overload, and Biological Assessment.Clinical interventions in aging · 2020Review
- Iron Metabolism: An Emerging Therapeutic Target in Critical Illness.Critical care (London, England) · 2019Review
- Iron deficiency diagnosed using hepcidin on critical care discharge is an independent risk factor for death and poor quality of life at one year: an observational prospective study on 1161 patients.Critical care (London, England) · 2018Observational
- Blood donors' physical characteristics are associated with pre- and post-donation symptoms - Donor InSight.Blood transfusion = Trasfusione del sangue · 2017Observational
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPrevalence of iron deficiency (ID) at intensive care (ICU) admission is around 25 to 40%. Blood losses are important during ICU stay, leading to iron losses, but prevalence of ID at ICU discharge is unknown. ID has been associated with fatigue and muscular weakness, and may thus impair post-ICU rehabilitation. This study assessed ID prevalence at ICU discharge, day 28 (D28) and six months (M6) after and its relation with fatigue.
methodsWe conducted this prospective, multicenter observational study at four University hospitals ICUs. Anemic (hemoglobin (Hb) less than 13 g/dL in male and less than 12 g/dL in female) critically ill adult patients hospitalized for at least five days had an iron profile taken at discharge, D28 and M6. ID was defined as ferritin less than 100 ng/L or less than 300 ng/L together with a transferrin saturation less than 20%. Fatigue was assessed by numerical scale and the Multidimensional Fatigue Inventory-20 questionnaire at D28 and M6 and muscular weakness by a hand grip test at ICU discharge.
resultsAmong 107 patients (men 77%, median (IQR) age 63 (48 to 73) years) who had a complete iron profile at ICU discharge, 9 (8.4%) had ID. At ICU discharge, their hemoglobin concentration (9.5 (87.7 to 10.3) versus 10.2 (92.2 to 11.7) g/dL, P =0.09), hand grip strength (52.5 (30 to 65) versus 49.5 (15.5 to 67.7)% of normal value, P =0.61) and visual analog scale fatigue scale (57 (40 to 80) versus 60 (47.5 to 80)/100, P =0.82) were not different from non-ID patients. At D28 (n =80 patients) and M6 (n =78 patients), ID prevalence increased (to 25 and 35% respectively) while anemia prevalence decreased (from 100% to 80 and 25% respectively, P <0.0001). ID was associated with increased fatigue at D28, after adjustment for main confounding factors, including anemia (regression coefficient (95%CI), 3.19 (0.74 to 5.64), P =0.012). At M6, this association disappeared.
conclusionsThe prevalence of ID increases from 8% at discharge to 35% six months after prolonged ICU stay (more than five days). ID was associated with increased fatigue, independently of anemia, at D28.
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