Inpatient iron deficiency detection and management: how do general physicians and gastroenterologists perform in a tertiary care hospital?

Fazal, Muhammad Waqas; Andrews, Jane M.; Thomas, Josephine; Saffouri, E

doi:10.1111/imj.13486

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…It can put patients at increased risk of death due to decreased oxygen transportation, cause cardiac arrhythmias, and decrease quality of life [1,2,6]. Iron-deficiency anemia has been poorly diagnosed and treated in inpatients in the past, with only 60-66% receiving adequate iron supplementation [8]. Only 60.2% of those who were admitted to the hospital with diagnostic criteria of iron-deficiency anemia were supplemented, consistent with prior studies.…”

Section: Discussionmentioning

confidence: 69%

“…Iron-deficiency anemia has been poorly diagnosed and treated in inpatients in the past with only 40-66% receiving adequate iron supplementation in tertiary care hospitals [8]. We hypothesized that patients whose admission to our institution revealed a new diagnosis of iron-deficiency anemia would not be reliably discharged on iron supplementation or have the diagnosis appropriately transmitted to their primary care physicians for further evaluation and treatment.…”

Section: Introductionmentioning

confidence: 99%

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Management of Iron-Deficiency Anemia on Inpatients and Appropriate Discharge and Follow-Up

2020

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Background:The aims of the study were to identify appropriate supplementation of iron for inpatients and to identify factors involved in appropriate discharge documentation and follow-up.Methods: This was a retrospective analysis of 103 patients at a community hospital in New York City.Results: A total of 57 (57/103, 55.3%) patients were admitted due to symptomatic anemia. Twenty (20/103, 19.4%) of those with iron-deficiency anemia had either esophagogastroduodenoscopy or colonoscopy. Gastroenterologist or hematologist was consulted for 45/103 (43.7%). Inpatient iron supplementation was given for 62/103 (60.2%) of patients; and 43/103 (41.7%) had blood transfusion. Upon discharge, 50/103 (48.5%) had appropriate documentation of irondeficiency anemia on discharge paperwork. Appropriate follow-up was done for 54/103 (52.4%). Iron supplementation was provided for 53/103 (51.5%) of patients. Having inpatient esophagogastroduodenoscopy or colonoscopy, blood transfusion, or symptomatic anemia had a statistical significance for likelihood of appropriate discharge documentation.Conclusions: Iron-deficiency anemia can have high rates of mortality and morbidity in the population. Appropriate discharge of patients with iron-deficiency anemia and factors related to this are paramount for clinicians in order to have the best patient outcomes.

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Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Management of Iron-Deficiency Anemia on Inpatients and Appropriate Discharge and Follow-Up

2020

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“…The sensitivity of these data is unknown, but previous data using a similar call-taking system suggest that approximately 83% of these patients have a final diagnosis of stroke. 17 Third, due to the remoteness of some regions, we did not use average drive times derived from population data, such as the centre point of census tracts, as used in previous reports. 11 Therefore, our data are only estimates of access to reperfusion services.…”

Section: Discussionmentioning

confidence: 99%

Strategic framework improves access to stroke reperfusion across the state of Victoria Australia

Bray

Denisenko

Campbell

et al. 2017

Internal Medicine Journal

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“…In the state of South Australia, however, it has become more routine to measure iron levels in patients admitted with acute GIB who are anemic at admission and/or have red blood cell (RBC) indices suggestive of ID-a result of increasing proactivity by gastroenterologists, despite no formal evidence-based guidance. This practice has developed from growing local awareness of the need for improvement in recognizing, investigating, and managing ID in hospital practice, 12 increasing recognition of the advantage of adopting restricted blood transfusion policy, and the associated role of IV iron. 13 The prevalence of anemia in the study by El-Halabi et al 11 was 77% (236/307) at hospital admission and 92% (282/307) during hospitalization.…”

Section: Iron Investigations and Prevalence Of Iron Deficiency/iron-d...mentioning

confidence: 99%

Management of iron‐deficiency anemia following acute gastrointestinal hemorrhage: A narrative analysis and review

Lanas

Andrews

Lau

et al. 2022

J of Gastro and Hepatol

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Many patients experiencing acute gastrointestinal bleeding (GIB) require iron supplementation to treat subsequent iron deficiency (ID) or iron-deficiency anemia (IDA). Guidelines regarding management of these patients are lacking. We aimed to identify areas of unmet need in patients with ID/IDA following acute GIB in terms of patient management and physician guidance. We formed an international working group of gastroenterologists to conduct a narrative review based on PubMed and EMBASE database searches (from January 2000 to February 2021), integrated with observations from our own clinical experience. Published data on this subject are limited and disparate, and those relating to post-discharge outcomes, such as persistent anemia and re-hospitalization, are particularly lacking. Often, there is no post-discharge follow-up of these patients by a gastroenterologist. Acute GIB-related ID/IDA, however, is a prevalent condition both at the time of hospital admission and at hospital discharge and is likely underdiagnosed and undertreated. Despite limited data, there appears to be notable variation in the prescribing of intravenous (IV)/oral iron regimens. There is also some evidence suggesting that, compared with oral iron, IV iron may restore iron levels faster following acute GIB, have a better tolerability profile, and be more beneficial in terms of quality of life. Gaps in patient care exist in the management of acute GIB-related ID/IDA, yet further data from large population-based studies are needed to confirm this. We advocate the formulation of evidence-based guidance on the use of iron therapies in these patients, aiding a more standardized best-practice approach to patient care.

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Inpatient iron deficiency detection and management: how do general physicians and gastroenterologists perform in a tertiary care hospital?

Abstract: There remains significant room for improvement in the recognition, investigation and management of ID in hospital practice in Australia.

Cited by 3 publications

References 8 publications

Management of Iron-Deficiency Anemia on Inpatients and Appropriate Discharge and Follow-Up

Management of Iron-Deficiency Anemia on Inpatients and Appropriate Discharge and Follow-Up

Strategic framework improves access to stroke reperfusion across the state of Victoria Australia

Management of iron‐deficiency anemia following acute gastrointestinal hemorrhage: A narrative analysis and review

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