What question did this study set out to answer?

To evaluate the effectiveness of different iron status definitions in predicting 1-year mortality in hospitalized patients with congestive heart failure.

January 10, 2026Journal of Clinical MedicineOpen Access

Prognostic Value of Different Iron Status Definitions in Congestive Heart Failure: A Retrospective MIMIC-IV Analysis of Risk Stratification and Mortality

Q: What does this research mean for the field?

Guidelines-defined iron deficiency in CHF patients is associated with higher 1-year mortality (56.1% vs. 29.4%; adjusted HR 4.36) compared to other iron status definitions. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

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Key result

Guideline-defined iron deficiency in CHF linked to ~336% higher 1-year mortality versus other definitions.

56.1% vs. 29.4%
HR 4.36

Why the study?

Inconsistent diagnostic criteria for iron deficiency in CHF, particularly regarding functional deficiency and hyperferritinemia, limit prognostic accuracy.

Does a combined Ferritin-TSAT model improve prognostic risk stratification for 1-year mortality compared to binary guideline iron deficiency definitions in hospitalized CHF patients?

Population

1839 hospitalised CHF patients from MIMIC-IV

Comparison

Different iron status definitions including guideline criteria, ferritin, TSAT, and a combined Ferritin-TSAT model

Design

Retrospective database analysis

Follow-up

365-day

Authors

AHAbdulla Zahi HouraniMedical University of Warsaw ASArman David SürmeliMedical University of Warsaw SDSai K. DevarapalliMedical University of Warsaw

Discussion

Member takes

Implication

Guidelines-defined iron deficiency flags high 1-year mortality risk in hospitalized CHF; supports consensus yet leaves open whether combined ferritin-TSAT models improve stratification.

Key Points

To evaluate the effectiveness of different iron status definitions in predicting 1-year mortality in hospitalized patients with congestive heart failure.
Retrospective analysis of MIMIC-IV data from 1839 CHF patients
Categorized iron status within 24 hours of admission using guideline ID and other models
Utilized adjusted Cox models to assess associations with mortality
Guideline-defined iron deficiency showed a 33.66% prevalence and was associated with a 56.1% 1-year mortality rate
Combined Ferritin-TSAT model improved differentiation between iron deficiency, intermediate iron levels, and hyperferritinemia
Adjusted hazard ratios indicate significant mortality risk differences among the subgroups, suggesting the combined model provides finer risk stratification

Structured PICO

Does a combined Ferritin-TSAT model improve prognostic risk stratification for 1-year mortality compared to binary guideline iron deficiency definitions in hospitalized CHF patients?

Population

1,839 hospitalised congestive heart failure (CHF) patients from the MIMIC-IV database

Intervention

Combined Ferritin-TSAT model for iron status classification (Low: guideline ID; Intermediate: ferritin 100–299 μg/L + TSAT ≥ 20%; High: ferritin ≥ 300 μg/L)

Comparator

Binary guideline definition of iron deficiency (ID vs. non-ID)

Outcome

365-day (1-year) mortalityhard clinical

A combined Ferritin-TSAT classification offers finer risk stratification for 1-year mortality in hospitalized CHF patients compared to binary guideline definitions of iron deficiency.

Cite This Study

Hourani et al. (2025) studied this question. Guidelines-defined iron deficiency in CHF patients associated with higher 1-year mortality (56.1% vs. 29.4%; adjusted HR 4.36) compared to other iron status definitions.

synapsesocial.com/papers/6963221991e05aa366cb8950 https://doi.org/10.3390/jcm15010244

Topics

HFrEF treatment Heart failure

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Implication

Guidelines-defined iron deficiency flags high 1-year mortality risk in hospitalized CHF; supports consensus yet leaves open whether combined ferritin-TSAT models improve stratification.

Prognostic Value of Different Iron Status Definitions in Congestive Heart Failure: A Retrospective MIMIC-IV Analysis of Risk Stratification and Mortality

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Prognostic Value of Different Iron Status Definitions in Congestive Heart Failure: A Retrospective MIMIC-IV Analysis of Risk Stratification and Mortality

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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