Challenges in the diagnosis of iron deficiency anemia in aged people

Moraes, Niele Silva de; Figueiredo, Maria Stella

doi:10.1016/j.bjhh.2017.03.005

Cited by 4 publications

(4 citation statements)

References 21 publications

(29 reference statements)

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“…Transferrin saturation is one of the biomarkers of iron deficiency anemia (IDB) which is cheap and widely available in most laboratories, [23] besides hemoglobin level measurement [24]. Another study also found that blood transferrin levels of elderly with anemia were significantly lower than those without (p<0.001) [25].…”

Section: Discussionmentioning

confidence: 99%

“…However, in this study's finding, the hemoglobin level and transferrin saturation decreased after three months of intervention. This result might be caused by the diseases the participants suffered, which were not adjusted as a confounder, such as inflammatory illnesses [23] and chronic kidney diseases [26] that correlate with serum transferrin saturation and anemia.…”

Section: Discussionmentioning

confidence: 99%

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A nutrition intervention study’s effect to hematology profiles on elderly group in social retirement home

Sudargo,

Suryani,

Widyaningrum

et al. 2024

IJPHS

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The increase in the elderly brings consequences, including a higher risk of disease. Inappropriate nutritional intake is also known as one of the risk factors related to the elderly's non-communicable diseases, and nutritional intervention is essential to improve the elderly nutritional status and quality of life. It was an interventional study with a before-after one-group approach. The study was conducted for three months (October-December 2021) in three social retirement homes. The intervention given was supplementation with additional protein sources and snacks each day. The biochemistry profiles were taken 2 times: before and after three months of intervention, comprised of HbA1c, lipid, transferrin, creatinine, and blood pressure level. The data will be analyzed for its normality before being processed with paired t-test or Wilcoxon signed rank based on the normality results. The analysis results show that there are significantly lower transferrin levels (p=0.040), an increase in cholesterol level (p=0.000), and low-density lipoprotein (LDL) level increased from 114.05±32.03 to 125.94±31.41 (p=0.000). There is also a remarkable decrease in hemoglobin (p=0.005) and high-density lipoprotein (HDL) levels. Conversely, there are an increase in HbA1C (p=0.007) and triglyceride level (p=0.005). There is no significant difference in creatinine level. We conclude that nutrition interventions have a significant effect on elderly blood profiles. However, to achieve an improvement, the study should consider physical activity and other variables that might be altering the results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A nutrition intervention study’s effect to hematology profiles on elderly group in social retirement home

Sudargo,

Suryani,

Widyaningrum

et al. 2024

IJPHS

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“…A major limitation of using Hb alone as a screening method is that the decrease in Hb levels occurs only when there is complete consumption of iron stores [2]. Serum ferritin is a reliable marker of bone marrow iron stores with high sensitivity and specificity making it the first‐line diagnostic tool for iron deficiency anaemia [3, 4]. Though unusual in healthy blood donors, the serum ferritin levels may be falsely raised in inflammatory conditions as it is an acute phase reactant.…”

Section: Introductionmentioning

confidence: 99%

Utility of reticulocyte haemoglobin content and immature reticulocyte fraction in early diagnosis of latent iron deficiency in whole blood donors

et al. 2021

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Background and Objectives: The present study was planned to assess the clinical utility of reticulocyte haemoglobin content (CHr) and immature reticulocyte fraction (IRF) in the early detection of latent iron deficiency in blood donors. Materials and Methods:The prospective longitudinal observational study was conducted using the purposive sampling method. Written informed consent was obtained and donors were allocated into the first-time (FTD) and regular donor (RD) group. The enrolled blood donors (n = 205 in each group) were followed up for two subsequent whole blood donations. Haemoglobin (Hb), CHr, IRF and serum ferritin values were recorded at enrolment and two follow-ups. Results:The sensitivity of CHr in detecting iron-deficient erythropoiesis (serum ferritin values ≤ 26 μg/dl) was 45% and 56.7%, specificity 96.7%, positive predictive value (PPV) 85.6% and 90.8% and negative predictive value (NPV) 80.1% and 78.7%, respectively in FTD and RD cohorts. The sensitivity of IRF was 45.1% and 44.8%, specificity 93.4% and 97.1%, PPV 74.8% and 90.4% and NPV 79.6% and 74.5%, respectively in both the cohorts.The sensitivity of CHr in detecting absent iron stores (serum ferritin values ≤ 15 μg/ dl) was 66.2% and 74.4%, specificity 92% and 90.6%, PPV 56.7% and 68.7% and NPV 94.5% and 92.8% among FTD and RD cohort, respectively. The sensitivity of IRF was 72.7% and 65.3%, specificity 90.3% and 94.3%, PPV 54.4% and 76% and NPV 95.4% and 90.8%, respectively in both the cohorts. Conclusion:Reticulocyte hemoglobin content and IRF can be used along with complete blood count for early detection of iron deficiency in blood donors using the same blood sample at no extra cost.immature reticulocyte fraction, latent iron deficiency, reticulocyte haemoglobin content Highlights• Reticulocyte hemoglobin content and immature reticulocyte fraction were found to have a high positive predictive value and negative predictive value in detecting iron deficiency in whole blood donors at an early stage.

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“…Consequently, diagnosing the underlying cause of anaemia is often complex. [12][13][14] More specifically, previous research estimated that in 14-33% of older persons with anaemia, the underlying cause is unknown. 1,12 In addition, anaemia is often under-diagnosed 15 and under-treated, as it is often considered a consequence of aging 12 and not as a specific symptom of disease.…”

Section: Introductionmentioning

confidence: 99%

Assessing the cost-effectiveness of a routine versus an extensive laboratory work-up in the diagnosis of anaemia in Dutch general practice

et al. 2018

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BackgroundEstablishing the underlying cause of anaemia in general practice is a diagnostic challenge. Currently, general practitioners individually determine which laboratory tests to request (routine work-up) in order to diagnose the underlying cause. However, an extensive work-up (consisting of 14 tests) increases the proportion of patients correctly diagnosed. This study investigates the cost-effectiveness of this extensive work-up.MethodsA decision-analytic model was developed, incorporating all societal costs from the moment a patient presents to a general practitioner with symptoms suggestive of anaemia (aged ≥ 50 years), until the patient was (correctly) diagnosed and treated in primary care, or referred to (and diagnosed in) secondary care. Model inputs were derived from an online survey among general practitioners, expert estimates and published data. The primary outcome measure was expressed as incremental cost per additional patient diagnosed with the correct underlying cause of anaemia in either work-up.ResultsThe probability of general practitioners diagnosing the correct underlying cause increased from 49.6% (95% CI: 44.8% to 54.5%) in the routine work-up to 56.0% (95% CI: 51.2% to 60.8%) in the extensive work-up (i.e. +6.4% [95% CI: −0.6% to 13.1%]). Costs are expected to increase slightly from €842/patient (95% CI: €704 to €994) to €845/patient (95% CI: €711 to €994), i.e. +€3/patient (95% CI: €−35 to €40) in the extensive work-up, indicating incremental costs of €43 per additional patient correctly diagnosed.ConclusionsThe extensive laboratory work-up is more effective for diagnosing the underlying cause of anaemia by general practitioners, at a minimal increase in costs. As accompanying benefits in terms of quality of life and reduced productivity losses could not be captured in this analysis, the extensive work-up is likely cost-effective.

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Challenges in the diagnosis of iron deficiency anemia in aged people

Cited by 4 publications

References 21 publications

A nutrition intervention study’s effect to hematology profiles on elderly group in social retirement home

A nutrition intervention study’s effect to hematology profiles on elderly group in social retirement home

Utility of reticulocyte haemoglobin content and immature reticulocyte fraction in early diagnosis of latent iron deficiency in whole blood donors

Assessing the cost-effectiveness of a routine versus an extensive laboratory work-up in the diagnosis of anaemia in Dutch general practice

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