{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T18:39:54Z","timestamp":1780598394360,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,7,16]],"date-time":"2023-07-16T00:00:00Z","timestamp":1689465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Ferric carboxymaltose (FCM) administration helps reduce transfusion requirements in the perioperative situation, which improves patient outcomes and reduces healthcare costs. However, there is increasing evidence of hypophosphataemia after FCM use. We aim to determine the incidence of hypophosphataemia after FCM administration and elucidate potential biochemical factors associated with the development of subsequent hypophosphataemia. A retrospective review of anonymised data of all FCM administrations in a single institution was conducted from August 2018 to August 2021. Each unique FCM dose administered was examined to assess its effect on Hb and serum phosphate levels within the subsequent 28\u2009days from each FCM administration. Phosphate levels were repeatedly measured within the 28\u2010day interval and the lowest phosphate level within that period was determined. Patients' serum phosphate levels within 28\u2009days of FCM administration were compared against normal serum phosphate levels within 2\u2009weeks before FCM administration. The odds ratios of various pre\u2010FCM serum markers were calculated to elucidate potential biochemical predictors of post\u2010FCM hypophosphataemia. In 3\u2009years, a total of 1296 doses of FCM were administered to 1069 patients. The mean improvement in Hb was 2.45\u2009g\/dL (SD\u2009=\u20091.94) within 28\u2009days of FCM administration, with the mean time taken to peak Hb levels being 6.3\u2009days (SD\u2009=\u20098.63), which is earlier than expected, but was observed in this study and hence reported. The incidence of hypophosphataemia &lt;0.8\u2009mmol\/L was 22.7% (<jats:italic>n<\/jats:italic>\u2009=\u2009186), and &lt;0.4\u2009mmol\/L was 1.6% (<jats:italic>n<\/jats:italic>\u2009=\u20099). This figure is lower than the numbers reported in previously published meta\u2010analyses given that routine checks of serum phosphate levels were not conducted initially and hence could possibly be higher. The odds of developing hypophosphataemia (&lt;0.8\u2009mmol\/L) were 27.7 (CI: 17.3\u201344.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) if baseline serum phosphate was less than 1\u2009mmol\/L. The odds of developing hypophosphataemia (&lt;0.8\u2009mmol\/L) were 1.3 (CI: 1.08\u20131.59, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) if the change in Hb levels observed after FCM administration were more than 4\u2009g\/dL. Hypophosphataemia after FCM administration is significant and FCM should be used by clinicians with caution.<\/jats:p>","DOI":"10.1111\/bjh.18979","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T01:25:00Z","timestamp":1689557100000},"page":"1199-1204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Incidence and predictors of hypophosphataemia after ferric carboxymaltose use\u2014A 3\u2010year experience from a single institution in Singapore"],"prefix":"10.1111","volume":"202","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3107-9391","authenticated-orcid":false,"given":"Zachary","family":"Chu","sequence":"first","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Cushway","sequence":"additional","affiliation":[{"name":"The Integrative Medical Centre by The Iron Suites  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Sengkang General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai\u2010Xiong","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Sengkang General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wee\u2010Ming","family":"Peh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Sengkang General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choong\u2010Tatt","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Sengkang General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan\u2010Yen","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Sengkang General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon G. K.","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Sengkang General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze\u2010Tong","family":"Tey","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sengkang General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fung\u2010Joon","family":"Foo","sequence":"additional","affiliation":[{"name":"Department of General Surgery Sengkang General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3717-4480","authenticated-orcid":false,"given":"Frederick H.","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of General Surgery Sengkang General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12797"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000648"},{"issue":"5","key":"e_1_2_10_4_1","first-page":"422","article-title":"Current misconceptions in diagnosis and management of iron deficiency","volume":"15","author":"Mu\u00f1oz M","year":"2017","journal-title":"Blood Transfus"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15030"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000237687"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-020-01694-x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2021.101592"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2019.01.018"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000012911"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2021.1912010"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25060"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.22450"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-021-01770-2"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1319"},{"issue":"7","key":"e_1_2_10_16_1","first-page":"355","article-title":"Severe hypophosphatemia in a patient with diabetic ketoacidosis and acute respiratory failure","volume":"67","author":"Liu PY","year":"2004","journal-title":"J Chin Med Assoc"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14643"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab852"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13114"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2021.116202"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2019.01.006"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S243462"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26100"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2021.1858406"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac433"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.18979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T09:37:55Z","timestamp":1694425075000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.18979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,16]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1111\/bjh.18979"],"URL":"https:\/\/doi.org\/10.1111\/bjh.18979","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,16]]},"assertion":[{"value":"2023-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}