Prevalence and factors associated with iron deficiency among patients hospitalized with acute decompensated heart failure at Mbarara regional referral hospital, southwestern Uganda

Background Iron deficiency is one of the most common comorbidities occurring among heart failure patients. Iron deficiency in heart failure is an independent predictor of heart failure outcomes. Data are scarce regarding its prevalence in our setting especially among patients presenting with acutely decompensated heart failure. Methods A nested cross-sectional study was conducted at MRRH including patients hospitalized with acute decompensated heart failure. Simple proportions were used for the prevalence of iron deficiency among patients hospitalized with ADHF, while multivariate logistic regression was used for associated factors, reporting adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results A total of 150 participants were enrolled. The median age was 54 years, with IQR of 40–67. The majority had NYHA functional class III [91 patients (60.7%)] and IV 38 patients (25.3%) respectively. The median systolic blood pressure was 114 (IQR 102–133), Hb 12.8g/dl (IQR11.5-14.1), NT-proBNP 9685 (IQR 2534–20631) and eGFR 53.5 (IQR 37.1–68.7). The median LV ejection fraction was 36.9 IQR (30–54), regarding etiology of HF, majority had dilated cardiomyopathy 44.9%. Comorbidities included Hypertension (85%), HIV (22%), diabetes mellitus (10.7%), and 11% had history of alcohol consumption. The prevalence of iron deficiency was 56 % (95% CI 47.7–64.1). In multivariate logistic regression, factors associated with iron deficiency among patients hospitalized with ADHF were; the presence of congestion (fluid overload) like pedal edema on physical examination aOR 3.197 ( 95% CI: 1.015–10.076; P = 0.047) and hs-CRP above 3mg/l aOR 7.982 ( 95% CI: 2.514–25.343; P < 0.001). Conclusion Our study shows that more than 50% of the patients with acute decompensated heart failure are iron deficient. The factors we found independently associated with ID are a high serum level of high-sensitivity CRP and evidence of congestion like pedal edema at admission. We recommend screening of patients hospitalized with ADHF for iron deficiency and thereafter targeted therapy to improve HF outcomes.