Association between Iron Deficiency Anemia and Thrombosis, a Population Based Study

Abstract

Iron deficiency anemia (IDA) has been associated with thrombosis in children, but this association has not been appropriately studied in other age groups. We hypothesize that IDA is a risk factor for thrombosis in all populations. The aim of our study is to evaluate the association between iron deficiency anemia and different types of thrombosis in all patients. Methods: We searched the medical records of all patients evaluated at a large hospital and outpatient medical center in Tampa, Florida utilizing the International Classification of Diseases 10th Edition (ICD-10). This coding system assigns standard acronyms to conditions, symptoms, and other factors of disease. We used the codes for iron deficiency anemia of all types, venous embolism and thrombosis, cerebrovascular disease, and retinal vascular occlusion. We then combined the codes in the database search to obtain the total number of patients with these conditions. Finally, we performed simple statistical analysis to compare the number and percentage of patients with thrombosis and IDA to patients with thrombosis and without IDA. Results: 2,539,231 patients were included in our database between 2010 and July 31st 2023. The age of this population was between 0-102 years-old. IDA was present in 66,693 patients (2.63%), venous embolism and thrombosis was present in 36,523 individuals (1.43%), cerebrovascular thrombosis was present in 14,159 patients (0.56%), and retinal vascular occlusion was present in 1,506 individuals (0.06%). Out of the 66,693 patients with IDA, 7,554 (11.3%) had venous embolism and thrombosis, 14,159 (0.56%) had cerebrovascular thrombosis, and 1,506 (0.06%) had retinal vascular occlusion. Out of the 2,472,538 patients without IDA, 28,969 (1.17%) had venous embolism and thrombosis, 12,172 (0.49%) had cerebrovascular thrombosis, and 1,276 (0.05%) had retinal vascular occlusion. When comparing the percentage of patients with IDA versus no-IDA, venous embolism and thrombosis was 10 times more prevalent, cerebrovascular thrombosis was 6 times more prevalent, and retinal vascular occlusion 6 times more prevalent in patients with IDA than in those without IDA in all age groups combined. Conclusions: In this population based study, the incidence of thrombosis was 6-10 times greater in patients with IDA compared to no-IDA. Our data suggests that IDA is a risk factor for thrombosis in all patients. Prospective studies might be needed to confirm our findings. Finally, our data suggests that treatment of IDA might decrease the risk of thrombosis.