From the Guidelines
Anemia severity is classified based on hemoglobin levels, with mild anemia defined as hemoglobin 11.0-11.9 g/dL, moderate anemia as 8.0-10.9 g/dL, and severe anemia as less than 8.0 g/dL in women aged 15 years and older, according to the World Health Organization 1.
Anemia Severity Classification
The classification of anemia severity is crucial for determining the appropriate treatment approach and urgency.
- Mild anemia: hemoglobin 11.0-11.9 g/dL
- Moderate anemia: hemoglobin 8.0-10.9 g/dL
- Severe anemia: hemoglobin less than 8.0 g/dL These cutoffs are based on the World Health Organization's definitions for women aged 15 years and older 1.
Importance of Accurate Classification
Accurate classification of anemia severity is essential for guiding clinical decision-making, as it determines the treatment approach and urgency.
- Mild anemia may be monitored with iron supplementation
- Severe anemia often requires urgent intervention, including possible blood transfusion Hemoglobin levels reflect the oxygen-carrying capacity of blood, with lower levels indicating reduced ability to deliver oxygen to tissues, which explains why symptoms worsen as anemia becomes more severe 1.
Comparison with Other Guidelines
Other guidelines, such as the ESPEN guideline, provide similar classifications for anemia severity, but with slightly different cutoffs for different populations 1. However, the World Health Organization's definitions are the most recent and widely accepted, and should be used as the primary guide for classifying anemia severity 1.
From the Research
Anemia Severity Levels
The severity levels of anemia can be categorized based on hemoglobin (Hb) levels. According to the studies, the following severity levels can be defined:
- Mild anemia: Hb levels between 10-12 g/dL for women and 11-13 g/dL for men 2, 3, 4
- Moderate anemia: Hb levels between 8-10.9 g/dL 3, 4
- Severe anemia: Hb levels less than 8 g/dL 3, 4
- Unexplained anemia: anemia that cannot be explained by an underlying disease or a specific pathological process, which might be due to the progressive resistance of bone marrow erythroid progenitors to erythropoietin, and a chronic subclinical pro-inflammatory state 2
Classification of Anemia
Anemia can be classified based on the underlying cause, such as:
- Iron deficiency anemia: characterized by low serum ferritin levels 5
- Vitamin B12 or folate deficiency anemia: characterized by high mean corpuscular volume (MCV) and low serum vitamin B12 or folate levels 5, 6
- Anemia of chronic disease: characterized by high serum ferritin levels and low serum iron levels 2
- Unexplained anemia: anemia that cannot be explained by an underlying disease or a specific pathological process 2
Diagnosis and Treatment
The diagnosis of anemia involves a detailed history and physical examination, assessment of risk factors for underlying conditions, and laboratory tests such as complete blood count (CBC) and serum ferritin levels 5. Treatment of anemia depends on the underlying cause and may include iron replacement therapy, vitamin B12 or folate supplementation, and blood transfusions in severe cases 5.