Abstract Number: PB1261
Meeting: ISTH 2020 Congress
Background: Acute heavy menstrual bleeding (HMB) in post-menarchal adolescents often leads to iron deficiency (ID) and anemia. Literature on the impact of intravenous (IV) iron therapy in such patients is lacking.
Aims: To evaluate the impact of IV iron therapy in post-menarchal adolescents hospitalized for acute HMB.
Methods: This was a retrospective cohort study of post-menarchal adolescents admitted to a tertiary care children’s hospital for acute HMB, approved by the institutional review board. Clinical/laboratory data from initial admission/follow-up were collected. The Wilcoxon rank-sum test, Fisher’s exact test or Chi-square test were used to test associations between variables. Logistic regression was used to test associations and estimate odds ratios with 95% confidence intervals.
Results: Eighty-six patients were admitted for acute HMB. Table 1 and 2 summarizes the patient demographic and characteristics. When compared to patients who did not receive, patients who received IV iron had significantly shorter median time to hemoglobin normalization (77 vs. 29 days, p=0.007) and ferritin normalization (74 vs 27 days, p=0.006). Hemodynamic instability (heart rate >100/minute, systolic blood pressure (BP)< 90mmHg or diastolic BP< 60mmHg) noted in 66/85 (78%), was not associated with red blood cell (RBC) transfusion (p=0.122), with 16/19 (84%) hemodynamically stable patients receiving RBC. Hemoglobin< 7g/dl (p=0.503), ferritin< 20ng/ml (p=0.311) or hemodynamically instability (p=0.481) were not associated with receiving IV iron.
|N Total||N (%)|
|Non-Hispanic: Caucasian||86||8 (9.3)|
|Non-Hispanic: Black||86||24 (27.9)|
|Non-Hispanic: Other||86||5 (5.8)|
[Table 1: Patient Demographic]
|N Total||Mean (SD)|
|Age at Menarche||85||11.5 (1.5)|
|Years from Menarche to HMB diagnosis||85||2.6 (1.8)|
|N Total||N (%)|
|Bleeding disorder present||86||9 (10.5)|
|Anemia (Hb <12 g/dl)||86||85 (98.8)|
|Iron deficiency (Ferritin <20 ng/ml)||61||56 (91.8)|
|RBC Transfusion||86||80 (93.0)|
|IV Iron therapy||84||18 (21.4)|
[Table 2: Patient Characteristics]
Conclusions: Our study shows that IV iron therapy is effective for anemia/ID management in post-menarchal adolescents hospitalized for acute HMB, with significantly faster normalization of hemoglobin/ferritin. RBC transfusion and IV iron use were independent of hemodynamic stability. Majority of hemodynamically stable patients received RBC; according to current recommendations, these patients could have been treated with IV iron alone, thereby avoiding RBC exposure. Future efforts to utilize IV iron therapy for hemodynamically stable patients will help to minimize transfusion requirement/exposure.
To cite this abstract in AMA style:Han H, Cohen AS, Staggers KA, Srivaths L. Impact of Intravenous Iron Therapy in Post-menarchal Adolescents Hospitalized with Acute Heavy Menstrual Bleeding [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/impact-of-intravenous-iron-therapy-in-post-menarchal-adolescents-hospitalized-with-acute-heavy-menstrual-bleeding/. Accessed November 26, 2020.
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