Audit of the prevalence and investigation of iron deficiency anaemia in patients with heart failure in hospital practice

2019 ◽  
Vol 96 (1134) ◽  
pp. 206-211
Author(s):  
Steny Simon ◽  
Adam Ioannou ◽  
Stuart Deoraj ◽  
Sofia Metaxa ◽  
Amit K J Mandal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Healthcare Professionals ◽  
Deficiency Anaemia ◽  
Heart Failure Patients ◽  
Qualitative Survey ◽  
Retrospective Audit ◽  
Iron Deficient ◽  
Iron Replacement

Purpose of the studyIron deficiency anaemia (IDA) is associated with increased morbidity and mortality in heart failure patients. The aim of our audit was to evaluate the current practice in diagnosis and assessment of IDA in patients admitted with heart failure.Study designWe conducted a retrospective audit of patients admitted to our hospital between January 2017 and June 2017 with a diagnosis of heart failure, and obtained data regarding each patient’s demographics and anaemic status. We also conducted a qualitative survey to assess healthcare professionals’ ability to diagnose IDA, and their knowledge of iron replacement in heart failure patients.ResultsOur audit identified 218 heart failure patients, nearly two-thirds (n=138, 63.3%) of which were anaemic. Of the 138 anaemic patients, only 40 had a full haematinic screen compared with 98 who had incomplete investigations (29% vs 71%, p=0.007). Iron studies were the most commonly performed haematinic investigation (n=87, 63%), and over half of these patients were iron deficient (n=49, 56.3%). Only 12 (24.5%) iron deficient patients were prescribed oral iron therapy, while 37 (75.5%) were left without iron replacement (X2=12.8, p=0.0003). Our survey demonstrated a lack of awareness among healthcare professionals with only 19.7% of participants being able to correctly define anaemia and 9.1% being aware of guidelines regarding treatment of IDA.ConclusionMany patients admitted to hospital with heart failure also have a concomitant diagnosis of anaemia. The aetiology of the underlying anaemia is often poorly investigated, and where IDA is identified it is poorly treated.

Poor efficacy of oral iron replacement therapy in pediatric patients with heart failure

2021 ◽  
pp. 1-8
Author(s):  
Kriti Puri ◽  
Joseph A. Spinner ◽  
Jacquelyn M. Powers ◽  
Susan W. Denfield ◽  
Hari P. Tunuguntla ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Transferrin Saturation ◽  
Systolic Heart Failure ◽  
Oral Iron ◽  
Wilcoxon Test ◽  
Iron Therapy ◽  
Oral Iron Therapy ◽  
Iron Deficient ◽  
Iron Replacement

Abstract Introduction: Iron deficiency is associated with worse outcomes in children and adults with systolic heart failure. While oral iron replacement has been shown to be ineffective in adults with heart failure, its efficacy in children with heart failure is unknown. We hypothesised that oral iron would be ineffective in replenishing iron stores in ≥50% of children with heart failure. Methods: We performed a single-centre retrospective cohort study of patients aged ≤21 years with systolic heart failure and iron deficiency who received oral iron between 01/2013 and 04/2019. Iron deficiency was defined as ≥2 of the following: serum iron <50 mcg/dL, serum ferritin <20 ng/mL, transferrin >300 ng/mL, transferrin saturation <15%. Iron studies and haematologic indices pre- and post-iron therapy were compared using paired-samples Wilcoxon test. Results: Fifty-one children with systolic heart failure and iron deficiency (median age 11 years, 49% female) met inclusion criteria. Heart failure aetiologies included cardiomyopathy (51%), congenital heart disease (37%), and history of heart transplantation with graft dysfunction (12%). Median dose of oral iron therapy was 2.9 mg/kg/day of elemental iron, prescribed for a median duration of 96 days. Follow-up iron testing was available for 20 patients, of whom 55% (11/20) remained iron deficient despite oral iron therapy. Conclusions: This is the first report on the efficacy of oral iron therapy in children with heart failure. Over half of the children with heart failure did not respond to oral iron and remained iron deficient.

463 THE USE OF FERINJECT TO MANAGE IRON DEFICIENCY ANAEMIA IN PATIENTS WITH NECK OF FEMUR FRACTURES

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
O Meakin ◽  
S Adejumo
Keyword(s):  
Iron Deficiency ◽  
Patient Group ◽  
Iron Deficiency Anaemia ◽  
Eligible Patient ◽  
Blood Transfusions ◽  
Neck Of Femur ◽  
Improvement Project ◽  
Deficiency Anaemia ◽  
Femur Fractures ◽  
Iron Deficient

Abstract Introduction Iron-deficiency anaemia is a condition that is regularly seen in patients admitted with neck of femur fractures (NOFF) and is associated with increased morbidity peri-operatively. Intravenous ferinject is a method of iron replacement that leads to a more rapid increase in haemoglobin than oral replacement, therefore is often more favourable in this patient group, leading to better patient outcomes. Method A quality improvement project was undertaken. An initial audit was conducted to analyse the demographic of patients with NOFF and to assess the current practice of the orthogeriatric team when managing iron deficiency anaemia. This reviewed NOFF patients admitted in July 2017. The indications and benefits of ferinject were distributed to the medical team, encouraging use clinically, and a further audit was performed 2 years later to compare outcomes and practice, reviewing patients with NOFF admitted July–September 2019. Results It was found that 87% of patients with NOFF are iron-deficient on admission, and that introducing the use of ferinject meant that 50% fewer blood transfusions were required. Additionally, it highlighted that those who received ferinject during their admission had a smaller range of discharge haemoglobin levels than those who did not. Finally, it was found that the use of ferinject did not affect the rates of readmission in the assessed patient cohort. Conclusions The introduction of the use of ferinject in NOFF patients with iron-deficiency anaemia leads to a reduction in the requirement of blood transfusions required and to a reduction of the range of discharge haemoglobin levels. Ferinject therefore aids in improved recovery of NOFF patients. It does not, however, appear to have any effect on readmission rates in this patient group. Further education is required amongst the orthogeriatric team about the indications and benefits of ferinject to ensure that all eligible patient receive ferinject, improving their recovery.

scholarly journals The prevalance of iron deficiency anaemia in heart failure and non-heart failure controls

2016 ◽  
Vol 75 (OCE3) ◽  
Author(s):  
C.P. Kerley ◽  
N. Glezeva ◽  
C.J. Watson ◽  
K. McDonald ◽  
M. Ledwidge
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Deficiency Anaemia

scholarly journals Low prevalence of iron-deficiency anaemia among Inuit preschool children: Nunavut Inuit Child Health Survey, 2007–2008

2010 ◽  
Vol 14 (8) ◽  
pp. 1415-1423 ◽  
Author(s):  
Angela Pacey ◽  
Hope Weiler ◽  
Grace M Egeland
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Cross Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Deficiency Anaemia ◽  
Reactive Protein ◽  
Iron Deficient ◽  
Household Crowding ◽  
Low Prevalence

AbstractObjectiveTo report the prevalence rates and correlates for anaemia, iron deficiency (ID) and iron-deficiency anaemia (IDA) among Inuit preschool-aged children.DesignA cross-sectional study assessed iron intake, demographic information, medical history, anthropometrics, Hb, ferritin, C-reactive protein and antibodies toHelicobacter pylori.SettingSixteen selected Inuit communities in Nunavut Territory, Canada.SubjectsInuit (n388) aged 3–5 years randomly recruited from communities.ResultsAnaemia (3–4 years: Hb < 110 g/l; 5 years: Hb < 115 g/l) was prevalent in 16·8 % of children. The prevalence of ID (ferritin < 12 μg/l) was 18·0 % and that of IDA was 5·4 %. When ID was defined as ferritin <10 μg/l, 10·8 % of children were iron deficient and 3·3 % had IDA. In multiple logistic regression, boys were more likely to be iron deficient (OR = 2·28, 95 % CI 1·17, 8·25), but no other risk factor emerged for ID. Three- to 4-year-olds were less likely than 5-year-olds to have anaemia from causes other than ID (OR = 0·11, 95 % CI 0·08, 0·58). Anaemia from other causes was more common among children residing in crowded homes (OR = 2·30, 95 % CI 1·37, 12·31) and those treated for past-year ear infection (OR = 1·35, 95 % CI 1·05, 7·21).ConclusionsThe low prevalence of ID and IDA is encouraging, but efforts are still needed to reduce rates as they continue to be higher than general population rates. Household crowding and infections may contribute to anaemia and warrant further research.

Some Properties of Human Platelet Monoamine Oxidase in Iron-Deficiency Anaemia

1976 ◽  
Vol 50 (6) ◽  
pp. 479-485 ◽  
Author(s):  
M. B. H. Youdim ◽  
D. G. Grahame-Smith ◽  
H. F. Woods
Keyword(s):  
Iron Deficiency ◽  
Monoamine Oxidase ◽  
Iron Deficiency Anaemia ◽  
Monoamine Oxidase Inhibitor ◽  
Normal Subjects ◽  
Heat Inactivation ◽  
Binding Studies ◽  
Deficiency Anaemia ◽  
Iron Deficient ◽  
Platelet Monoamine Oxidase

1. Monoamine oxidase activity in platelets prepared from the blood of patients with iron-deficiency anaemia was significantly lowered when compared with that in platelets from normal subjects. 2. The Km values of the platelet enzyme for the substrates dopamine, 5-hydroxytryptamine, phenylethylamine and kynuramine were similar for the platelet enzyme from iron-deficient and normal groups. 3. Heat-inactivation studies showed that the platelet monoamine oxidase from iron-deficient subjects was more labile to this treatment, when compared with the platelet enzyme from normal subjects. 4. The sensitivity of platelet monoamine oxidase to the inhibitors, clorgyline and deprenil, was increased in iron-deficiency anaemia. 5. Binding studies with the 14C-binding irreversible monoamine oxidase inhibitor, deprenil, showed that the amount of enzyme capable of binding this inhibitor was lowered by 48% in platelets from iron-deficient patients when compared with platelets from normal subjects. 6. The results show that there is a lowered amount of active enzyme in platelets from iron-deficient subjects. It is suggested that iron is necessary either for the synthesis of monoamine oxidase apoenzyme or is a cofactor for an enzyme which attaches flavin—adenine dinucleotide covalently to the monoamine oxidase apoenzyme.

scholarly journals Standardization & Development of Rat Model with Iron Deficiency Anaemia Utilising Commercial Available Iron Deficient Food

2019 ◽  
Vol 16 (1) ◽  
pp. 71-77
Author(s):  
Mansee Kapil Thakur ◽  
Smital Sameer Kulkarni ◽  
Nimain Mohanty ◽  
Nitin. N. Kadam ◽  
Niharika S. Swain
Keyword(s):  
Iron Deficiency ◽  
Rat Model ◽  
Iron Deficiency Anaemia ◽  
Test Group ◽  
Peripheral Smear ◽  
Deficient Diet ◽  
Deficiency Anaemia ◽  
Iron Deficient ◽  
Body Weights ◽  
Before And After

Many research centres have developed various animal models with Iron Deficiency Anaemia (IDA) by using iron deficient feeds as well as different chemicals. Model for iron deficiency anaemia (IDA) in rats has been created by the use of iron elimination from diet components as much as possible. The present study elaborates and concludes the development of IDA rat model by investigating different parameters like body weight, haematological indices, peripheral smear, immunoassay studies and histopathological studies using commercially available iron deficient diet. 12 Wistar albino female rats weighing 180-200 gm were selected with normal haemoglobin range of 12 - 15 g/dL purchased from Bombay Veterinary College, Parel and divided into two groups – Control (3 no. of rats) and Test (9 no. of rats). The test group was fed with iron deficient diet (VRK Nutritional Solutions) whereas control group was fed with standard diet. The time duration of the study was 5 weeks (35 days) and 6 weeks (42 days). Retro orbital blood for both control and treated was drawn at both time intervals so as to analyse haematological and immunoassay studies. Peripheral smear staining was carried out to observe the gross morphology of RBCs for iron deficient and control rats. The body weights were recorded before and after treatment and statistical significance was calculated. Post exposure rats were dissected and organs like heart, kidney, liver, lungs and spleen were collected for histopathological analysis. Our results showed decreased levels of hemoglobin (Hb), hematocrit (HCT), mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), reticulocyte count, serum iron (SI), serum ferritin (SF) and an increase in total iron binding capacity (TIBC). in IDA animals exposed to 42 days of iron deficient diet. Significant difference (p<0.5) was observed in body weights of rats when compared with the data before and after treatment. The peripheral smear has indicated microcytic hypochromic RBCs in test group confirming development of IDA model. The histopathological results revealed the abnormality at cellular level like congestion of blood vessels in heart, congestion and centrilobular hepatocyte with inflammatory cell infiltration in liver, perivasculitis in lungs and decrease in white pulp in spleen whereas kidney were found normal. Our results clearly demonstrate iron deficient rat model when administered with IDA feed. This model can be used for estimation of efficiency of new food products and food supplements enriched with iron.

scholarly journals A case study of Human iron deficiency Anaemia in different age groups from Ujjain (M.P.) India

2021 ◽  
Vol 33 (3) ◽  
pp. 12-18
Author(s):  
MANJU JUNWAL ◽  
◽  
BHAI ISMAIL ◽  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Age Groups ◽  
Public Health Problem ◽  
Socioeconomic Level ◽  
Red Cell ◽  
Deficiency Anaemia ◽  
Iron Deficient ◽  
Red Cell Count

Iron deficiency Anaemia is the most common case of nutritional Anaemia worldwide and is a public health problem in developing countries; characterized by abnormal red cell count (MCV, MCHC). Iron deficiency Anaemia associated with fatigue, skin paleness, weakness etc. The aim of the study is to determine the risk factors for iron deficiency Anaemia among population of Ujjain district (M.P.). Both male and female iron deficient patients were studied from the SS hospital and CHL applo hospitals during Jan. 2012 to Dec. 2012. A group of 6828 patients were studied for iron deficiency Anaemia in different age groups. A total of 4549 female and 2279 males were studied. Information was collected about sex, socioeconomic level. It is inferred that the percentage of anaemia is more in women compared to men.

scholarly journals Prevalence and spectrum of iron deficiency anaemia in heart failure patients

2019 ◽  
Vol 7 (1) ◽  
pp. 132
Author(s):  
Gaurav Mohan ◽  
Gurinder Mohan ◽  
Manish Chandey ◽  
Avneet Kaur ◽  
Trimaan Singh Sikand ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Serum Ferritin ◽  
Iron Deficiency Anaemia ◽  
Large Scale ◽  
Binding Capacity ◽  
Tertiary Care ◽  
Transferrin Saturation ◽  
Care Hospital ◽  
Deficiency Anaemia

Background: To study the prevalence and pattern of iron deficiency (ID)in heart failure (HF) patients with or without anaemia.Methods: This is a single-centre observational study, conducted at a tertiary care hospital of Punjab. Patients were selected based on validated clinical criteria-Framingham criteria. The iron parameters were done during the study including serum iron, serum ferritin, total iron binding capacity, and transferrin saturation (TSAT), to diagnose iron deficiency anaemia. Anaemia was defined as haemoglobin (Hb) < 13g/dl in males and <12 g/dL in females, based on WHO definition. Absolute iron deficiency is defined as serum ferritin < 100 mg/L and functional ID was defined as normal serum ferritin (100–300 mg/L) with low TSAT (<20%).Results: A total of 120 patients of Heart Failure (54% males and 46% females) were studied. Most of the patients were of high-functional NYHA class (Class IV NYHA n=45). Iron Deficiency was present in 60% patients with 31.66% patients having absolute and 28.33% patients having functional ID. Nearly one-fifth of the patients were having ID but without anemia, signifying importance of workup of Iron deficiency other than haemoglobin levels.Conclusions: Study highlights the neglected burden of ID in HF patients in India. This study suggests further large-scale studies to better characterize this easily treatable condition and considering routine testing in future Indian guidelines.

A Preliminary Study of Iron Absorption by Whole Body Counting and Correlation with DFO Excretion

1975 ◽  
Vol 14 (01) ◽  
pp. 74-80
Author(s):  
M. M. Gupta ◽  
R. Manchanda ◽  
L. Bhattacharyya ◽  
M. Bhargva ◽  
S. Kumar ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Iron Absorption ◽  
Whole Body ◽  
Healthy Controls ◽  
Deficiency Anaemia ◽  
Iron Deficient ◽  
Body Counting ◽  
Preliminary Study ◽  
Whole Body Counting

SummaryA preliminary study of iron absorption by whole body counting was carried on a group of 16 women. The cases included 8 patients suffering from iron deficiency anaemia and various infections as well as 8 healthy controls. High iron absorption is associated with iron dificiency, these changes being more marked in iron deficient controls than in those with infection or malignancy. In iron deficient controls results of whole body counting correlate very well with other haematological investigations.

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