scholarly journals Refinement and validation of the IDIOM score for predicting the risk of gastrointestinal cancer in iron deficiency anaemia

2020 ◽  
Vol 7 (1) ◽  
pp. e000403 ◽  
Author(s):  
Orouba Almilaji ◽  
Carla Smith ◽  
Sue Surgenor ◽  
Andrew Clegg ◽  
Elizabeth Williams ◽  
...  
Keyword(s):  
Pilot Study ◽  
High Risk ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Haemoglobin Concentration ◽  
Internal Validation ◽  
Mean Cell Volume ◽  
Deficiency Anaemia ◽  
Fast Tracking ◽  
Gi Cancer

ObjectiveTo refine and validate a model for predicting the risk of gastrointestinal (GI) cancer in iron deficiency anaemia (IDA) and to develop an app to facilitate use in clinical practice.DesignThree elements: (1) analysis of a dataset of 2390 cases of IDA to validate the predictive value of age, sex, blood haemoglobin concentration (Hb), mean cell volume (MCV) and iron studies on the probability of underlying GI cancer; (2) a pilot study of the benefit of adding faecal immunochemical testing (FIT) into the model; and (3) development of an app based on the model.ResultsAge, sex and Hb were all strong, independent predictors of the risk of GI cancer, with ORs (95% CI) of 1.05 per year (1.03 to 1.07, p<0.00001), 2.86 for men (2.03 to 4.06, p<0.00001) and 1.03 for each g/L reduction in Hb (1.01 to 1.04, p<0.0001) respectively. An association with MCV was also revealed, with an OR of 1.03 for each fl reduction (1.01 to 1.05, p<0.02). The model was confirmed to be robust by an internal validation exercise. In the pilot study of high-risk cases, FIT was also predictive of GI cancer (OR 6.6, 95% CI 1.6 to 51.8), but the sensitivity was low at 23.5% (95% CI 6.8% to 49.9%). An app based on the model was developed.ConclusionThis predictive model may help rationalise the use of investigational resources in IDA, by fast-tracking high-risk cases and, with appropriate safeguards, avoiding invasive investigation altogether in those at ultra-low predicted risk.

Iron-Deficiency Anaemia: Its Effect on Transfer Factor for the Lung (Diffusing Capacity) and Ventilation and Cardiac Frequency during Sub-Maximal Exercise

1972 ◽  
Vol 42 (3) ◽  
pp. 325-335 ◽  
Author(s):  
J. E. Cotes ◽  
J. M. Dabbs ◽  
P. C. Elwood ◽  
A. M. Hall ◽  
A. McDonald ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Transfer Factor ◽  
Iron Deficiency Anaemia ◽  
Maximal Exercise ◽  
Haemoglobin Concentration ◽  
Placebo Treatment ◽  
Deficiency Anaemia ◽  
Cardiac Frequency ◽  
Control Subjects ◽  
Exercise Ventilation

1. Measurements of transfer factor and sub-maximal exercise ventilation and cardiac frequency have been made on twenty women with iron-deficiency anaemia (Hb 8–9 g/100 ml) before and after ‘treatment’ with iron or placebo tablets and on control subjects. 2. The exercise ventilation, cardiac frequency and oxygen uptake were independent of haemoglobin concentration but the transfer factor was lower in the test than in control subjects and was increased by iron but not by placebo treatment. The results support the validity of the reaction-rate data for carbon monoxide with oxyhaemoglobin of Roughton & Forster (1957) despite evidence to the contrary from other studies. 3. In interpretation of sub-maximal exercise ventilation and cardiac frequency in iron-deficiency anaemia no allowance need be made for variation in haemoglobin concentration in the range 8–15 g/100 ml. For transfer factor a correction should be made by using a variant of the relationship of Roughton & Forster (1957).

scholarly journals Evaluation of safety and efficacy of intravenous iron sucrose therapy for moderate anaemia in antenatal women

2019 ◽  
Vol 8 (10) ◽  
pp. 2258
Author(s):  
K. P. Poojitha ◽  
B. S. B. Mallika ◽  
K. V. Siva Prasad
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Haemoglobin Concentration ◽  
Intravenous Iron ◽  
Iron Sucrose ◽  
Efficacy And Safety ◽  
Deficiency Anaemia ◽  
Anaemia In Pregnancy ◽  
Moderate Anaemia ◽  
In Pregnancy

Background: Prevalence of iron deficiency anaemia is high in developing countries like India. Treatment of iron deficiency anaemia in pregnancy is very important to bring down maternal mortality rate as blood loss during delivery can lead to death of the patient. The aim and objective of our study is to evaluate the efficacy and safety of intravenous iron sucrose infusions in antenatal women admitted in hospital suffering from moderate iron deficiency anaemia. Special emphasis was given to observe adverse drug effects.Methods: This was a prospective observational study conducted in Obstetrics and Gynaecology department, Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh. Study period was two months and study population included antenatal women with gestational age less than 37 weeks with moderate iron deficiency anaemia. Peripheral smear was examined for microcytic hypochromic anaemia and they were treated with intravenous infusion of iron sucrose. Haemoglobin levels were checked before and 5 weeks after iron infusions. Monitoring was done for adverse reactions.Results: Out of 322 admissions, 95% were found to be anaemic. 72 patients were suffering from moderate anaemia from which 25 have been included and treated with intravenous iron sucrose infusions. They were observed for efficacy and safety parameters. Two minor adverse events were reported (fever with chills and angioedema of lips) and they were excluded from study. Mean haemoglobin concentration was found to be raised from 7.08±0.73 (SD) to 11.33±0.48 (SD) within 5 weeks for 23 patients.Conclusions: Iron sucrose infusion is safe and effective for anaemia in pregnancy.

scholarly journals The effect of iron-deficiency anaemia on two indices of nutritional status, prealbumin and transferrin

1980 ◽  
Vol 43 (2) ◽  
pp. 375-379 ◽  
Author(s):  
F. Delpeuch ◽  
A. Cornu ◽  
P. Chevalier
Keyword(s):  
Iron Deficiency ◽  
Nutritional Status ◽  
Iron Deficiency Anaemia ◽  
Haemoglobin Concentration ◽  
Significant Negative Correlation ◽  
Deficiency Anaemia ◽  
Percentage Saturation ◽  
Blood Haemoglobin ◽  
Two Indices ◽  
Children Under 5

1. Serum prealbumin, transferrin and iron concentrations were measured in ninety-two north Cameroonian children under 5 years of age. The results were grouped according to the blood haemoglobin concentration range in order to show the interactions of anaemia with prealbumin and transferrin concentrations.2. Transferrin concentration showed a significant negative correlation with serum Fe and percentage saturation of transferrin values. Prealbumin concentration showed a significant direct correlation with haemoglobin but did not correlate with either serum Fe or percentage saturation of transferrin.3. It is concluded that in regions where Fe-deficiency anaemia is endemic transferrin concentration may be of little value in determining nutritional status. On the contrary, prealbumin seems to be more useful.

The Effects of an Intravenous Iron Infusion on Pre-Operative Haemoglobin Concentration in Iron Deficiency Anaemia: A Retrospective Observational Study. (Preprint)

2021 ◽  
Author(s):  
Guy Nicholls ◽  
Rajan Mehta ◽  
Karen Mcveagh ◽  
Matt Egan
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Adverse Reactions ◽  
Haemoglobin Concentration ◽  
Intravenous Iron ◽  
Surgical Patients ◽  
Deficiency Anaemia ◽  
Post Infusion ◽  
Iv Iron ◽  
Iron Based

BACKGROUND An iron infusion pathway using Ferrinject®(ferric carboxymaltose) was implemented at Southend University Hospital for pre-operative surgical patients with iron deficiency anaemia undergoing major surgery. This was based on a treatment algorithm proposed by Munting et al, based on the international consensus statement on peri-operative management of anaemia and NICE guidelines. This states intravenous iron is indicated when oral iron is poorly tolerated, ineffective, there is insufficient time to surgery, or due to functional iron deficiency. OBJECTIVE Our objective was to study the degree of change in adult haemoglobin concentration (Hb g/L) after infusion at the time of surgery. METHODS Data was retrospectively collected on all surgical patients that received an iron infusion pre-operatively for iron deficiency anaemia from July 2019 to April 2020. Non-surgical patients, obstetrics, paediatrics and those without a post infusion haemoglobin level were excluded. Data collected included: pre and post infusion Hb, ferritin, and transferrin (post infusion results closest to surgery were collected), correct or incorrect dose of IV iron received (dose based on baseline Hb and weight) and any adverse reactions noted. RESULTS 32 surgical patients with iron deficiency anaemia received intravenous iron between July 2019 and April 2020 prior to surgery. The average pre and post iron infusion haemoglobin concentration across the cohort was 97 g/L and 114 g/L respectively (18% increase p= 0.001). 2 (6%) patients had a post transfusion Hb ≥ 130 g/L prior to surgery after infusion. 9 patients had both a pre and post infusion ferritin level recorded which showed an increase from 12 μg/L pre infusion to 94 μg/L (p=0.02) post infusion. 23 (72%) patients were did not receive the full dose of IV iron based on their Hb and weight. 75% of patients received an iron infusion >2 weeks prior to surgery with 25% < 2 weeks before their surgery. There was an average increase in Hb of 22% (21 g/L 95% CI 13-28) and 5% (5 g/L 95% CI 1-10) (p=0.03) respectively across the two groups. There were no documented adverse reactions to the infusion. CONCLUSIONS IV iron is an effective intervention to improve haemoglobin concentration in iron deficiency anaemia despite the majority of cases not receiving the full dose of IV iron based on their baseline Hb and weight. Increasing interval time between infusion and surgery was associated with a greater increase in Hb with only a minimal increase seen if given less than 2 weeks before.

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