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Thank you for attending THSNA 2026. The virtual meeting is now closed.
Thank you for attending THSNA 2026. The virtual meeting is now closed.
Presentation Details
| Iron Deficiency Can Increase the Risk of Venous Thromboembolism in Hospitalized Patients with Polycythemia Vera: A Nationwide Analysis (THSNA �Travel Awardee) Kavya Balusu, Purva Shah, Candrika D.Khairani, Peter Kouides. Rochester General Hospital, Rochester, NY, USA |
Abstract
Background: Thrombosis is the leading cause of morbidity and mortality in patients with polycythemia vera (PV), a myeloproliferative neoplasm. Iron deficiency is common in patients with PV as a consequence of therapeutic phlebotomy. Iron-deficient microcytic red blood cells have reduced deformability and can increase blood viscosity, leading to a hypercoagulable state and potentially increasing the risk of venous thromboembolism (VTE). Objective: The aim of this study is to investigate whether concurrent iron deficiency in hospitalized patients with PV is associated with an increased risk of VTE. Methods: We performed a retrospective analysis of the National Inpatient Sample (NIS) database from 2017 to 2021. ICD-10 codes were used to identify hospitalized patients with PV, iron deficiency, and VTE, along with demographic characteristics, comorbidities, and clinical outcomes. Statistical analysis was performed using STATA BE 17.0. Multivariate logistic regression was used to estimate the adjusted odds ratio (OR) of developing VTE among PV patients with concurrent iron deficiency, after adjusting for demographic variables and comorbidities. Results: Among 21,331 hospitalized patients with a diagnosis of PV (mean age 70.65 ± 13.97 years; 45.03% female), 18.7% (n=3989) had venous thromboembolism (VTE). Of these, 47.7% were female, and the most common race was white (80.7%). Overall, 7.3% of them had iron deficiency, 27% were smokers, 7.8% were obese, and 6.6% had thrombophilia. The most common site of VTE was deep vein thrombosis of the extremities (72.1%), followed by pulmonary embolism (45.5%). Portal vein thrombosis occurred in 7.3%, and 2.5% of them had thrombosis of other veins. Multivariate logistic regression showed that iron deficiency was significantly associated with VTE (OR 1.26; 95% CI 1.10-1.45, p = 0.001) after adjusting for potential confounders (gender, race, smoking, alcohol use, obesity, diabetes, hypertension, hyperlipidemia, chronic kidney disease, end-stage renal disease, and thrombophilia). VTE was associated with an increased risk of inpatient mortality (OR 1.07; 95% CI 0.89-1.28), although this was not statistically significant (p = 0.434). Interestingly, iron deficiency itself was associated with a statistically significant decreased risk of inpatient mortality (OR 0.70; 95% CI 0.51-0.97, p = 0.034). Conclusions: Concurrent iron deficiency in hospitalized patients with PV is associated with a statistically significant increased risk of venous thromboembolism. Screening for iron deficiency and careful treatment of iron deficiency (lest rebound polycythemia occurs) in PV patients may help reduce the frequency of VTE and the associated morbidity and mortality. Increased use of cytoreductive therapy may also reduce the need for therapeutic phlebotomy and help achieve this goal. Limitations of our study include the inability to establish temporal associations; therefore, prospective studies are needed to confirm these findings and to further clarify the underlying pathophysiology.
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No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.