Trial reportCritical care (London, England)2021
Impact of treating iron deficiency, diagnosed according to hepcidin quantification, on outcomes after a prolonged ICU stay compared to standard care: a multicenter, randomized, single-blinded trial.
Trial report in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02276690 (Medical Economic Analysis of the Interest of Hepcidin Quantitation by Quantitative Mass Spectrometry for the Diagnosis of Iron Deficiency in Anemic Critically Ill Patients), which is not on this map. Cited by 19 papers.
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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.
Medical Economic Analysis of the Interest of Hepcidin Quantitation by Quantitative Mass Spectrometry for the Diagnosis of Iron Deficiency in Anemic Critically Ill Patients
Who cites it
19 citing papers in PubMed, 41 citations in OpenAlex.
- Practical Anemia Bundle and Hemoglobin Recovery in Critical Illness: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Micronutrients and ICU-Acquired Weakness: A Narrative Review.Journal of clinical medicine · 2026Review
- Anemia of Critical Illness: A Concise Definitive Review in Critical Care.Critical care medicine · 2026Review
- Budget Impact of Preoperative Anemia Management, the First Pillar of Patient Blood Management, on the Romanian Healthcare System.Clinical drug investigation · 2026Article
- The synergy of nutritional risk and iron deficiency as a predictor of mortality in older emergency department patients.Frontiers in medicine · 2026Article
- Is the Concentration of Trace Elements Zinc, Selenium, Copper, Manganese, and Iron a Predictor of Clinical Outcomes in Critically Ill Trauma Patients?Biological trace element research · 2025Article
- Intravenous Sodium Ferric Gluconate Complex for Hospitalized Pediatric Patients with Iron Deficiency Anemia.Children (Basel, Switzerland) · 2025Article
- Diagnostics: Markers of Body Iron Status.Advances in experimental medicine and biology · 2025Review
- What do we know about micronutrients in critically ill patients? A narrative review.JPEN. Journal of parenteral and enteral nutrition · 2025Review
- Postoperative anemia: is there a role for iron replacement therapy?Blood transfusion = Trasfusione del sangue · 2025Article
- Iron Metabolism in the Recovery Phase of Critical Illness with a Focus on Sepsis.International journal of molecular sciences · 2024Review
- Personalized nutrition therapy in critical care: 10 expert recommendations.Critical care (London, England) · 2023Review
- Association between anaemia and hospital readmissions in patients undergoing major surgery requiring postoperative intensive care.Anaesthesia · 2023Article
- Practical Anemia Bundle for Sustained Blood Recovery (PABST-BR) in critical illness: a protocol for a randomised controlled trial.BMJ open · 2022Article
- Early Post-Hospitalization Hemoglobin Recovery and Clinical Outcomes in Survivors of Critical Illness: A Population-Based Cohort Study.Journal of intensive care medicine · 2022Observational
- Patient blood management in the ICU: A narrative review of the literature.European journal of anaesthesiology and intensive care · 2022Review
- Targeted treatment of iron deficiency in prolonged critical illness: an opportunity to improve survival or not?Critical care (London, England) · 2021Article
- Iron Deficiency Defined by Hepcidin in Critically Ill Patients.Critical care (London, England) · 2021Article
- Importance of assessing biomarkers and physiological parameters of anemia-induced tissue hypoxia in the perioperative period.Brazilian journal of anesthesiology (Elsevier)Review
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Authors and funding
14 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundAnemia is a significant problem in patients on ICU. Its commonest cause, iron deficiency (ID), is difficult to diagnose in the context of inflammation. Hepcidin is a new marker of ID. We aimed to assess whether hepcidin levels would accurately guide treatment of ID in critically ill anemic patients after a prolonged ICU stay and affect the post-ICU outcomes.
methodsIn a controlled, single-blinded, multicenter study, anemic (WHO definition) critically ill patients with an ICU stay ≥ 5 days were randomized when discharge was expected to either intervention by hepcidin treatment protocol or control. In the intervention arm, patients were treated with intravenous iron (1 g of ferric carboxymaltose) when hepcidin was < 20 μg/l and with intravenous iron and erythropoietin for 20 ≤ hepcidin < 41 μg/l. Control patients were treated according to standard care (hepcidin quantification remained blinded). Primary endpoint was the number of days spent in hospital 90 days after ICU discharge (post-ICU LOS). Secondary endpoints were day 15 anemia, day 30 fatigue, day 90 mortality and 1-year survival.
resultsOf 405 randomized patients, 399 were analyzed (201 in intervention and 198 in control arm). A total of 220 patients (55%) had ID at discharge (i.e., a hepcidin < 41 μg/l). Primary endpoint was not different (medians (IQR) post-ICU LOS 33(13;90) vs. 33(11;90) days for intervention and control, respectively, median difference - 1(- 3;1) days, p = 0.78). D90 mortality was significantly lower in intervention arm (16(8%) vs 33(16.6%) deaths, absolute risk difference - 8.7 (- 15.1 to - 2.3)%, p = 0.008, OR 95% IC, 0.46, 0.22-0.94, p = 0.035), and one-year survival was improved (p = 0.04).
conclusionTreatment of ID diagnosed according to hepcidin levels did not reduce the post-ICU LOS, but was associated with a significant reduction in D90 mortality and with improved 1-year survival in critically ill patients about to be discharged after a prolonged stay.
trial registrationwww.clinicaltrial.gov NCT02276690 (October 28, 2014; retrospectively registered).
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