Management Of Anemia Research Articles

Standardizing the evaluation and management of iron deficiency anemia secondary to heavy menstrual bleeding in the emergency department.

Comprehensive guidelines for the management of iron deficiency anemia (IDA) in adolescents with heavy menstrual bleeding (HMB) presenting to the emergency department (ED) are lacking, leading to variability in care. We aimed to standardize the evaluation and management of these patients through the development and implementation of an evidence-based algorithm using quality improvement methodology. Baseline data of the target population identified variability across four key measures of clinical management: therapy choice and administration, laboratory evaluation, hematology service consultation, and patient disposition. Literature review and consensus from pediatric hematology and gynecology providers informed a draft algorithm that was refined in an iterative multidisciplinary process. From December 2022 to July 2023, we aimed to achieve a 25% relative increase in patients to receive optimal management per the algorithm, while using sequential Plan-Do-Study-Act (PDSA) cycles. Process measures focusing on provider documentation and balancing measures, such as ED length of stay, were assessed concurrently. Forty-nine patients were evaluated during four PDSA cycles. Improvement of ≥40% above baseline regarding recommended therapy administration was achieved across four PDSA cycles. Adherence to recommended therapy choice improved from 57% (baseline) to 100%, minimal laboratory evaluation from 14% to 83%, hematology consultation from 36% to 100%, and appropriate disposition from 71% to 100%. ED length of stay remained stable. Implementation of a standardized algorithm for management of IDA secondary to HMB in adolescents in the ED increased adherence to evidence-based patient care.

Evaluating Therapeutic Potential and Safety Profile of Desidustat for Anaemia Management in Patients with CKD: A Prospective, Open-Label, Single-Centre Study

Evaluating Therapeutic Potential and Safety Profile of Desidustat for Anaemia Management in Patients with CKD: A Prospective, Open-Label, Single-Centre Study

Association of Risk of Death and Hemoglobin (hgb) Variability in Anemia Management of Patients on Hemodialysis

Association of Risk of Death and Hemoglobin (hgb) Variability in Anemia Management of Patients on Hemodialysis

Adaptability of clinical pharmacist led interventions in the management of anemia of chronic renal disease: optimizing care

Renal anemia is a common comorbidity in chronic kidney disease (CKD) patients, typically treated with erythropoiesis-stimulating agents (ESAs) like erythropoietin. However, both over- and under-treatment are prevalent. In 2008, the Pharmacy Council of India introduced the Pharm.D course to enhance pharmaceutical care in clinical settings. While extensive studies in other countries highlight the benefits of clinical pharmacists' interventions, Indian research on this topic is limited. This prospective randomized controlled trial included CKD patients not on dialysis, with serum creatinine levels of 2-6 mg/dL and hemoglobin (Hb) levels below 12 g/dL. Participants were divided into three subgroups based on baseline Hb levels: < 10 g/dL (Group I), 10-12 g/dL (Group II), and >12 g/dL (Group III). ESAs and iron supplements were adjusted to maintain Hb levels of 10-12 g/dL. Quality of life was assessed using the Short Form Health Survey-36 questionnaire. Out of 448 participants, those in the pharmacist intervention group showed a significant shift towards Group II by the trial's end, compared to the control group. The study demonstrated a significant improvement in quality of life and physical performance, particularly for those in Group II, indicating that maintaining Hb levels at 10-12 g/dL is optimal for Indian CKD patients. This trial exemplifies the profound impact clinical pharmacists can have on patient care, highlighting their crucial role in improving healthcare outcomes through active participation and targeted interventions in clinical settings.

Usage of the Anemia Control Model Is Associated with Reduced Hospitalization Risk in Hemodialysis.

The management of anemia in chronic kidney disease (CKD-An) presents significant challenges for nephrologists due to variable responsiveness to erythropoietin-stimulating agents (ESAs), hemoglobin (Hb) cycling, and multiple clinical factors affecting erythropoiesis. The Anemia Control Model (ACM) is a decision support system designed to personalize anemia treatment, which has shown improvements in achieving Hb targets, reducing ESA doses, and maintaining Hb stability. This study aimed to evaluate the association between ACM-guided anemia management with hospitalizations and survival in a large cohort of hemodialysis patients. This multi-center, retrospective cohort study evaluated adult hemodialysis patients within the European Fresenius Medical Care NephroCare network from 2014 to 2019. Patients treated according to ACM recommendations were compared to those from centers without ACM. Data on demographics, comorbidities, and dialysis treatment were used to compute a propensity score estimating the likelihood of receiving ACM-guided care. The primary endpoint was hospitalizations during follow-up; the secondary endpoint was survival. A 1:1 propensity score-matched design was used to minimize confounding bias. A total of 20,209 eligible patients were considered (reference group: 17,101; ACM adherent group: 3108). Before matching, the mean age was 65.3 ± 14.5 years, with 59.2% men. Propensity score matching resulted in two groups of 1950 patients each. Matched ACM adherent and non-ACM patients showed negligible differences in baseline characteristics. Hospitalization rates were lower in the ACM group both before matching (71.3 vs. 82.6 per 100 person-years, p < 0.001) and after matching (74.3 vs. 86.7 per 100 person-years, p < 0.001). During follow-up, 385 patients died, showing no significant survival benefit for ACM-guided care (hazard ratio = 0.93; p = 0.51). ACM-guided anemia management was associated with a significant reduction in hospitalization risk among hemodialysis patients. These results further support the utility of ACM as a decision-support tool enhancing anemia management in clinical practice.

Impact of Serum Phosphate on Hemoglobin Level: A Longitudinal Analysis on a Large Cohort of Dialysis Patients

Background/Objectives: Phosphate is a macro-element involved in all cellular energetic processes. As about 90% of the phosphate filtered by the glomerulus is excreted by kidneys, the impairment of renal function and the consequent over-secretion of parathyroid hormone and fibroblast growth factor 23 results in the increase in the serum phosphate levels. The association between phosphate and hemoglobin is controversial, as both direct and indirect relationships have been reported. The present study aims to investigate the relationship between phosphate and hemoglobin in a large prospective, longitudinal cohort including dialysis patients from the Sicilian Registry of Nephrology, Dialysis, and Transplantation. Methods: In this prospective cohort study, we included 6263 hemodialysis patients to achieve a total of 120,462 repeated measurements of serum phosphate and hemoglobin over time. The longitudinal association between phosphate and hemoglobin was analyzed by univariate and multivariate Linear Mixed Models. Results: The mean age was 66 ± 16 years and the median dialysis vintage was 5 months [IQR: 2–16]. Mean and median values of hemoglobin and phosphate were 10.7 g/dL (SD 1.3 g/dL) and 4.6 mg/dL [IQR 3.9–5.5 mg/dL], respectively. The multivariate model, adjusted for potential confounders, confirmed the positive association between serum phosphate and hemoglobin [adjβ = 0.13, 95%CI 0.03–0.23, p = 0.01)]. These results were confirmed in analyses stratified for the use of phosphate binders. Conclusions: In our large cohort of dialysis patients, we found a linear, direct relationship between phosphate and hemoglobin levels. As a reduction in phosphate is associated with a parallel reduction in hemoglobin levels, hypophosphatemia can accentuate anemia in dialysis patients. Our results generate the hypothesis that monitoring serum phosphate in clinical practice might provide a better management of anemia.

Oral Liposomal Iron Versus Injectable Iron Sucrose for Anemia Treatment in Non-dialysis Chronic Kidney Disease Patients: A Non-inferiority Study.

Introduction Anemia is a prevalent and persistent complication in chronic kidney disease (CKD), particularly in advanced stages, contributing to the deterioration of renal function and diminishing patients' quality of life. Iron supplementation constitutes a cornerstone of anemia management in this population. Among various iron formulations, liposomal iron has emerged as a promising option due to its enhanced efficacy in replenishing iron reserves and improved tolerability. Objective This study aims to assess the comparative effects of intravenous and liposomal oral iron on hemoglobin levels in non-dialysis CKD patients. Additionally, it seeks to evaluate the rate of hemoglobin correction, iron reserve status during treatment, and therapeutic tolerance to these interventions. Materials and methods A randomized controlled trial enrolled CKD patients (stages 3-5, not on dialysis) with iron deficiency anemia (hemoglobin ≤ 12 g/dL, ferritin ≤ 100 ng/mL, transferrin saturation ≤ 25%). Participants were allocated to receive either daily oral liposomal iron (Group OS) at a dosage of 30 mg or intravenous iron-hydroxide sucrose complex weekly (Group IV) for three months. Follow-up extended through the treatment phase and two months post-withdrawal. Results Thirty-one CKD patients were randomized into two groups: 14 received intravenous iron (IV group) and 17 received oral iron (OS group). After excluding four patients, the final cohort comprised 27 individuals (IV group: n=13, OS group: n=14). Both iron treatments resulted in progressive hemoglobin increases, with the IV group showing a mean increase of 14.65% (p=0.049) compared to 4.78% (p=0.003) in the OS group. Secondary analysis revealed significant increases in ferritin levels (p<0.001) and transferrin saturation (TSAT) levels (p=0.031) in the IV group. Post-treatment follow-up demonstrated stable hemoglobin levels in the OS group and a consistent increase in ferritin levels in the IV group. Adverse reactions predominantly included hypotension in the IV group (4 (30.7%)) and constipation in the OS group (4 (28.4%)). Discussion and conclusion Anemia remains a significant challenge in CKD patients. Our study compares oral liposomal iron to injectable iron for anemia treatment, aiming to minimize hospitalizations for iron infusion, preserve venous capital, and mitigate potential harmful side effects. We found oral liposomal iron to be a safe and effective option for correcting anemia in non-dialysis CKD patients, albeit with lower efficacy in replenishing iron stores compared to IV iron. Comparative analysis with similar studies supports the non-inferiority of oral liposomal iron, although IV iron retains superiority in replenishing iron reserves.

Adherence to patient blood management strategy in patients with gastrointestinal bleeding: a prospective nationwide multicenter study.

Patient blood management (PBM) adherence in clinical practice is unclear. This real-world practice study assessed the management of patients with gastrointestinal (GI) bleeding after the implementation of the PBM strategy. This was a nationwide multicenter and prospective study involving consecutive adults with GI bleeding between March 2019 and March 2021. Patients were examined according to hemoglobin (Hb) level at admission (<7 g/dl, n = 93; 7-8 g/dl, n = 47; 8-9 g/dl, n = 61; and >9 g/dl, n = 249). Study outcomes measures were morbidity and mortality during hospitalization and at 3- and 6-month follow-up. Appropriate anemia or iron deficiency management was considered when adherence to PBM policy was higher than 75%. A total of 450 patients (57.6% men, median age: 74 years, interquartile range: 63-82) were included. Overall, 55.1% and 59.3% of patients received transfusion and iron supplementation, respectively. The rates of appropriate transfusion and iron supplementation adherence were 90.9% (range: 86.9-93.5%, P = 0.109) and 81.8% (range: 78.5-85.1%, P = 0.041), depending on Hb level, respectively. No associations were observed between adherence to the PBM strategy and length of stay (P = 0.263) or risk of further bleeding (P = 0.742). Patients who were transfused [hazard ratio (HR): 0.79, 95% confidence interval (CI): 0.27-0.85] and iron supplemented (HR: 0.91, 95% CI: 0.38-1.41), however, appropriately achieved a lower risk of death. Age (HR: 1.12, 95% CI: 1.12-1.25) and further bleeding (HR: 39.08, 95% CI: 4.01-181.24) were poor prognostic factors. No serious adverse events were reported. In this nationwide study, there is a high level of adherence and safety of PBM for the treatment of GI bleeding. Adherence to the PBM strategy improved outcomes in patients with GI bleeding.

Anemia and Erythropoietin Use Among Hemodialysis Chronic Kidney Disease Patients at Rumah Sakit Umum Siloam

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic kidney disease (CKD) affects an estimated 8-16% of the population and is increasing in prevalence. Anemia, a common and significant complication of CKD, is primarily caused by reduced erythropoietin production, which is essential for red blood cell production. Erythropoietin, a kidney-produced hormone, stimulates bone marrow to produce red blood cells. This study examines trends in the use of erythropoiesis-stimulating agents (ESAs) and the management of anemia in dialysis CKD patients before and after the implementation of ESA reimbursemen.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This cohort study was conducted at Rumah Sakit Umum Siloam, Tangerang, Indonesia, from February to July 2017. Patients who received blood transfusions or iron supplements during the study were excluded. Data collected included age, gender, dry weight, history of diabetes mellitus, hypertension, hemodialysis adequacy, and nutritional status. Statistical analysis with a 95% confidence interval (CI) was used to assess the association between hemoglobin levels (Hb) and erythropoietin use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Sixty patients completed the study. The proportion of anemic patients (Hb &amp;lt;10 g/dL) increased from 22 (36.7%) to 28 (46.7%) after erythropoietin administration. A mean dose of 6000 IU/week (CI: 4679 to 7321 IU/week) was effective in achieving target hemoglobin levels, while a dose of 4131 IU/week (CI: 3479 to 4782 IU/week) was sufficient to maintain them. Additionally, a dosage of 103.31 IU/kg/week increased hemoglobin by 1 g/dL in anemic patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Erythropoietin use should be optimized given the increasing prevalence of anemia. A dosage of 103.31 IU/kg/week is recommended to achieve target hemoglobin levels, while 4131 IU/week is suggested for maintaining hemoglobin within the target range. &lt;/p&gt;

Reducing Viral Load Impact: Blood Transfusions as a Complementary Approach in HIV Treatment

Blood transfusions have traditionally been associated with the management of anemia in individuals living with HIV; however, their potential role as a complementary approach in reducing viral load impact is gaining attention. This review explores how blood transfusions can enhance immune function, improve oxygen delivery, and support the efficacy of antiretroviral therapy (ART), thereby contributing to better health outcomes for patients. By addressing complications associated with HIV, such as anemia and immune dysfunction, blood transfusions may play a crucial role in optimizing treatment strategies and enhancing the overall quality of life for individuals living with the virus. The relationship between viral load and immune function is critical in HIV management, as high viral loads are associated with increased morbidity and mortality. Blood transfusions can mitigate the negative effects of viral load by improving the physiological conditions necessary for an effective immune response. Enhanced oxygenation from transfusions supports immune cell proliferation and activity, potentially leading to better control of viral replication and lower viral load levels. Moreover, improving hemoglobin levels through transfusions can reduce fatigue, increase treatment adherence, and promote active participation in ART. Keywords: anemia, blood transfusions, HIV, immune response, viral load

Improving Cognitive Function: Blood Transfusions and Neurological Benefits in HIV Management

HIV-associated neurocognitive disorders (HAND) continue to affect a significant number of individuals despite the widespread use of antiretroviral therapy (ART). This review explores the potential benefits of blood transfusions in improving cognitive function among HIV patients. Blood transfusions, primarily used to treat anemia, can enhance oxygen delivery to the brain, thereby ameliorating cognitive deficits. Anemia is a common comorbidity in HIV, and its correction through blood transfusions has been associated with improvements in attention, memory, and executive function. Beyond addressing anemia, blood transfusions may also offer neuroprotective effects by modulating systemic inflammation. Chronic inflammation, a hallmark of HIV infection, contributes significantly to neurocognitive decline. By reducing levels of pro-inflammatory cytokines, blood transfusions can potentially mitigate neuroinflammation and protect against neuronal damage. Clinical studies have shown that HIV patients receiving blood transfusions for anemia management exhibit slower cognitive decline, suggesting a broader role for transfusions in preserving neurological health. While promising, the use of blood transfusions in HIV management must be carefully considered due to associated risks such as transfusion reactions and iron overload. Keywords: HIV, cognitive function, blood transfusions, neurological benefits, neurocognitive disorders

Postoperative Intravenous Iron Infusion in Anemic Colorectal Cancer Patients: An Observational Study.

Anemia is the most common extraintestinal symptom of colorectal cancer, with a prevalence of 30-75%. While the preoperative anemia in this patient population has been well studied and its correction 4-6 weeks prior to surgery is recommended when feasible, there is a paucity of data regarding the management of postoperative anemia, which has a prevalence of up to 87% in these patients. To address this issue, we conducted an observational cohort study of surgically treated postoperative anemic patients with colorectal cancer. The objective of this study was to evaluate the effect of intravenous ferric carboxymaltose on the correction of postoperative anemia by postoperative day 30 (POD30). The primary outcome was the change in hemoglobin on POD30, while the secondary outcomes were the change in iron and other laboratory parameters, postoperative complications and transfusions. The results demonstrated that patients treated with intravenous iron exhibited a significant increase in hemoglobin levels by POD30, along with a concomitant increase in hematocrit, ferritin, and transferrin saturation levels, compared to the control group. The findings imply that patients undergoing colorectal cancer surgery with anemia that was not corrected in the preoperative setting may benefit from early postoperative intravenous iron infusion.

Successful Management of Miliary Tuberculosis with Concomitant Anemia: A Case Report

Background: Miliary tuberculosis (TB) is a disseminated and potentially fatal form of TB characterized by the hematogenous spread of Mycobacterium tuberculosis, often complicated by anemia of chronic disease. The diagnosis and management of miliary TB, particularly in conjunction with anemia, can be challenging, especially in resource-limited settings. Case presentation: We report the case of a 20-year-old male from a remote region in Eastern Halmahera, Indonesia, who presented with progressive shortness of breath, productive cough, night sweats, unintentional weight loss, and generalized weakness. Clinical examination revealed signs of anemia and respiratory distress. Laboratory investigations confirmed microcytic hypochromic anemia and a positive GeneXpert MTB/RIF test. Chest radiography demonstrated diffuse miliary nodules, consolidation, and cavitation, establishing the diagnosis of miliary TB with concomitant anemia. The patient received a standard six-month anti-tuberculosis therapy regimen, along with supportive care and targeted treatment for anemia and associated symptoms. The patient demonstrated significant clinical and hematological improvement, leading to discharge after 11 days of hospitalization. Follow-up assessments confirmed continued progress and the absence of complications. Conclusion: This case underscores the critical importance of maintaining a high index of suspicion for miliary TB in patients presenting with respiratory and constitutional symptoms, even in the absence of traditional risk factors. The presence of anemia can further complicate the clinical picture. Prompt diagnosis through a combination of clinical assessment, laboratory investigations, and imaging studies, followed by the immediate initiation of appropriate treatment, including the management of anemia, is paramount for achieving favorable outcomes in patients with miliary TB. The case also emphasizes the necessity for comprehensive care and follow-up to ensure sustained recovery and prevent relapse.

Epidemiology of Anaemia in Children under Five in Uganda: Current Trends, Challenges, and Strategic Approaches

Anaemia in children under five years old is a significant public health issue in Uganda, affecting over half of the vulnerable population and posing challenges to their health and development. The issue is influenced by nutritional deficiencies, infectious diseases, socioeconomic factors, and limited healthcare access. Clinical manifestations include pallor, fatigue, and developmental delays, and early detection is difficult due to non-specific symptoms, resource constraints, and cultural practices. The impact of anaemia on child health and development is profound, affecting physical growth, cognitive and motor skills, and overall well-being. Nutritional interventions, such as iron supplementation, fortified foods, and dietary education, are crucial for managing anaemia. Effective healthcare responses and policies, including routine screenings, treatment programs, and community outreach, are also necessary. Preventive measures and treatment programs are crucial for combating malaria and other infectious diseases. Community-based approaches, including training health workers and implementing grassroots education programs, are essential for improving anaemia management. Addressing gender dynamics and socioeconomic determinants is vital for reducing anaemia rates. Monitoring and evaluation frameworks are essential for assessing the effectiveness of anaemia control programs and guiding future efforts. In conclusion, a coordinated approach integrating nutritional, healthcare, environmental, and socioeconomic strategies is necessary to combat anaemia in Uganda. Through continued efforts and collaboration, the burden of anaemia can be mitigated, leading to improved health outcomes for children under five. Keywords: Anaemia, Children, Uganda, Current Trends, Challenges, Strategic Approaches

The Case for the Role of Primary Care in Patient Blood Management.

Patient blood management (PBM) is a patient-centered evidence-based strategy designed to preserve a patient's own blood and improve health outcomes. The effectiveness of PBM programs is now well-established globally within tertiary and secondary sectors, with demonstrable outcome benefits and cost savings. However, the role of primary care and the general practitioner in PBM is poorly understood. Yet the essential attributes of primary care, including access, continuity, coordination, and comprehensiveness, align well with PBM principles, enabling general practitioners to provide personalized holistic management of anemia for the community. The skill set of general practitioners in integrating and continuing care through the transition period after hospitalization is especially important. General practitioners are well-suited to the roles of health promotion and prevention, and have the potential to deliver substantial population health benefits. Given the public health imperative of this condition, it is vital that policy-makers appropriately support the role of general practitioners with financing, education, and resources for PBM in primary care.

A Study on the of Nutrition, Health and Hygiene Counselling impact on Iron Deficiency Anaemia

Iron deficiency anemia (IDA) is a prevalent nutritional disorder, especially among women and children in developing countries. This study investigates the impact of nutrition, health, and hygiene counseling on the prevalence and management of iron deficiency anemia. Through a combination of dietary modifications, health education, and hygiene practices, the study aims to evaluate improvements in hemoglobin levels and overall health outcomes. Participants included women of reproductive age and children from a rural community, who were provided with structured counseling sessions over six months. Baseline and post-intervention data on hemoglobin levels, dietary intake, and hygiene practices were collected and analyzed. The results demonstrate significant improvements in hemoglobin levels and a reduction in the incidence of IDA, highlighting the effectiveness of comprehensive counseling as a sustainable intervention strategy.

ANEMIA PATTERN IN PATIENTS WITH CHRONIC KIDNEY DISEASES PRESENTED AT TERTIARY CARE HOSPITAL

Anemia is a common complication in patients with chronic kidney disease (CKD) and contributes significantly to morbidity. Understanding the patterns and severity of anemia within this population can guide more effective management strategies. Objective: To assess the pattern and severity of anemia in patients with chronic kidney disease. Methods: This cross-sectional study was conducted from January 2024 to July 2024, involving 250 anemic CKD patients aged 18 years and above. The study was carried out at a nephrology care facility, with participants selected based on predefined inclusion and exclusion criteria. Data on demographic information, laboratory profiles, and anemia patterns were collected. Anemia was classified into mild, moderate, and severe categories. Statistical analysis was performed using SPSS version 24 to establish associations between the severity of CKD and the type of anemia. Results: Among the patients, 59.2% had normochromic anemia, 18.8% had hypochromic anemia, and 14% had macrocytic anemia. Moderate anemia was the most prevalent severity, observed in 51.2% of cases, followed by mild anemia in 41.6% and severe anemia in 7.2%. A significant association was noted between the severity of CKD and the type of anemia, particularly with normochromic anemia being more prevalent in patients with moderate CKD. Conclusion: The study concludes that normochromic anemia is the most predominant pattern of anemia in CKD patients, followed by hypochromic and macrocytic anemia. These findings underscore the importance of regular monitoring and tailored anemia management in CKD patients to improve overall patient outcomes.

Optimizing RBC Transfusion Strategies in Traumatic Brain Injury: Insights on Early Resuscitation and Cerebral Oxygenation.

Effective early resuscitation and maintenance of brain oxygenation are critical for improving the outcomes of patients with severe traumatic brain injury (TBI). Red blood cell (RBC) transfusion plays a vital role in this process. Although RBC transfusion can enhance cerebral oxygenation and stabilize hemodynamics, it also poses significant risks including transfusion-related lung injury and transfusion-associated circulatory overload, highlighting the importance of meticulous transfusion management. This review explores transfusion strategies during the early resuscitation phase and the management of anemia in patients with severe TBI, focusing on appropriate treatment targets, utilizing monitoring-based personalized approaches, and summarizing recent research and current insights.

Navigating anemia and anticoagulation in elderly patients undergoing orthopedic surgery: strategies for preventing complications and implementing treatments.

Elderly populations face an increased risk of anemia, leading to elevated transfusion requirements during surgery, especially major orthopedic procedures. Anemia itself increases the risk of thromboembolic events, thus compounding complications in elderly individuals. Polypharmacy and the prevalent use of oral anticoagulants (OAC), particularly for atrial fibrillation, contribute to bleeding risks in this population. Data available in the literature on the peri-operative management of anemia in patients taking OAC is limited and often heterogeneous. This narrative case-based review focuses on the peri-operative management of elderly patients on OAC undergoing major orthopedic surgery. PubMed/Medline was used to search for relevant literature. With reference to two cases, we critically evaluate the literature, and focus on risk factors, and preventive and therapeutic strategies as fundamental tools to reduce bleeding and correct anemia as soon as possible in elderly patients undergoing major orthopedic surgery. Peri-operative management of these patients, especially those on OAC, requires a balanced approach considering bleeding and thrombotic risks. Intravenous iron therapy and tranexamic acid emerge as valuable strategies in minimizing transfusion requirements and optimizing patients' outcomes.

Assessment of anemia in cases of acute myocardial infarction in a tertiary care hospital in South India

Background: Anemia is a known risk factor for ischemic heart disease and heart failure. It is also associated with increased mortality in acute myocardial infarction (AMI) patients. The study aimed to determine the anemia status of AMI patients and educate them on anemia and its impact on health. Methods: This was a cross-sectional study conducted among 150 AMI patients admitted to the ICCU of Government General Hospital Srikakulam, Andhra Pradesh over 3 months. Hemoglobin levels were recorded and patients were classified as non-anemic, mildly, moderately, or severely anemic based on WHO criteria. Patients’ sociodemographic profiles and risk factors were also collected. Results: Of the 150 patients (mean age 59.6 years), 70% were males. 83% of patients had anemia- 67% mild, 12% moderate, and 4% severe. The 50-65 years age group reported the highest frequency of mild anemia cases (38 out of 54). Absence of anemia was highest among the younger 45-50 years group (3 out of 15). Anemia was higher in females, and patients with a vegetarian diet had comparatively more anemia than those consuming a mixed diet. Additionally, 24% of the cases of anemia were in the 65-75 age group. Conclusions: A high prevalence of anemia was found among AMI patients. Counselling can help improve health by increasing awareness of anemia management. Screening AMI patients for anemia and therapeutic interventions were recommended.