Impact Of Iron Deficiency Anemia Research Articles

Impact of iron deficiency anemia on academic achievement among female university students in Saudi Arabia.

Anemia, particularly iron deficiency anemia (IDA), is a prevalent health issue globally and in Saudi Arabia, especially among young adult females. This study investigates the association between anemia and academic achievement among female students at the Female Health Campus of Jazan University, Jazan, Saudi Arabia. This cross-sectional study included 118 randomly selected participants aged 18-22. A validated questionnaire was administered to the study participants. The participants underwent blood tests for complete blood count (CBC) parameters and iron profile analysis. The study reported that 52.5% of the female students had anemia and low serum iron levels. Regarding academic performance, significant positive correlations were found between various CBC parameters including white cell count, hemoglobin, hematocrit, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, and serum iron. However, no significant correlations were observed between red blood cell count and platelet count with academic performance. Demographic variables were also associated with a higher odds ratio of anemia. The study highlights the prevalence of anemia among female students and its potential impact on academic achievement. The current study underscores the importance of addressing anemia in young adult females and implementing appropriate interventions to improve their educational outcomes.

The Impact of Iron Deficiency Anaemia on the Incidence and Severity of Febrile Convulsions in Paediatric Patients - Prospective Cohort Study

The Impact of Iron Deficiency Anaemia on the Incidence and Severity of Febrile Convulsions in Paediatric Patients - Prospective Cohort Study

Exploring the Impact of Iron Deficiency Anaemia on Glycated Haemoglobin A1c Levels in Pregnant and Non-Pregnant Women: A Systematic Review.

Haemoglobin A1C (HbA1c) is fundamental in monitoring glycaemic control during pregnancy. However, several conditions could affect this test's accuracy, including iron deficiency anaemia (IDA). Hence, this systematic review delves into the underexplored connection between IDA, iron replacement therapy (IRT), and haemoglobin A1C (HbA1c) during pregnancy. An electronic search of the Cochrane, MEDLINE, and Embase databases was conducted by six authors. From a comprehensive search strategy, 968 records were obtained. After applying the inclusion and exclusion criteria, seven studies were included, comprising 365 women selected for analysis. Six studies indicated a positive correlation between IDA and HbA1c levels, while one found no correlation. The average HbA1c level of the included studies in pregnant women was 5.64%. In comparison, it was found that non-pregnant women had lower HbA1c levels. Among the included studies, the mean HbA1c levels decreased from 5.1% to 4.89% after treating pregnant women with IRT. The review emphasises the complexity of interpreting HbA1c levels in pregnant women with IDA, highlighting the influence of pregnancy-induced physiological changes. In addition, this suggests that HbA1c should not be the sole criterion for diabetes management in pregnant women with IDA. Future research should focus on alternative glycaemic monitoring methods unaffected by IDA.

A-70 | Impact of Iron Deficiency Anemia On Percutaneous Coronary Intervention Outcomes Among Young Women With Acute Coronary Syndrome: A Nationwide Propensity Matched Analysis [2016 -2020]

A-70 | Impact of Iron Deficiency Anemia On Percutaneous Coronary Intervention Outcomes Among Young Women With Acute Coronary Syndrome: A Nationwide Propensity Matched Analysis [2016 -2020]

FETO/Maternal Complications in Iron Deficiency Anemia during Pregnancy and Labor

Background: Iron deficiency anemia (IDA) is a prevalent nutritional disorder globally, especially in developing countries, impacting both maternal and fetal health. The condition exacerbates the risk of adverse pregnancy outcomes, including increased morbidity and mortality rates. Objective: This study aimed to examine the prevalence and impact of IDA on feto-maternal health during pregnancy and labor, as well as to evaluate the efficacy of antenatal care programs in managing this condition. Methods: A six-month cross-sectional study was conducted at Shaikh Zayad Hospital, Larkana, from October 2021 to March 2022. Fifty pregnant women, ranging from primigravida to multigravida, were recruited through emergency and outpatient departments. Comprehensive data collection included demographic information, clinical history, and a full spectrum of laboratory tests for IDA. The severity of anemia and related complications were assessed, and the collected data were analyzed using SPSS version 25. Results: Of the participants, 74% suffered from moderate anemia, while 12% and 14% had mild and severe anemia, respectively. Serum ferritin levels indicated iron deficiency in 40% of the women, with an elevated total iron-binding capacity (TIBC) in 60% of cases. Maternal complications were prevalent, with 52% encountering unspecified emergency conditions and 16% experiencing postpartum hemorrhage. Fetal complications included intrauterine growth restriction (30%), intrauterine death (18%), and neonatal death (10%). Conclusion: IDA presents a significant health risk during pregnancy, correlated with a high incidence of maternal and fetal complications. This study emphasizes the importance of proactive management and monitoring of iron levels throughout pregnancy. Establishing comprehensive antenatal care that includes nutritional education and iron supplementation is crucial for preventing IDA and improving pregnancy outcomes.

Impact of Iron Deficiency Anemia on Hemoglobin A1c Levels in Diabetic and Non-Diabetic Pregnant Women

Impact of Iron Deficiency Anemia on Hemoglobin A1c Levels in Diabetic and Non-Diabetic Pregnant Women

Impact of Iron Deficiency Anemia on Postoperative Outcomes of Thoracolumbar Spinal Fusion (2+ levels) on Patients With Adult Spinal Deformity With Minimum 2-Year Follow-Up

Impact of Iron Deficiency Anemia on Postoperative Outcomes of Thoracolumbar Spinal Fusion (2+ levels) on Patients With Adult Spinal Deformity With Minimum 2-Year Follow-Up

Prevalence and Predictors of Iron Deficiency Anemia among Children in Saudi Arabia

Introduction: The long-term impact of iron deficiency anemia on female children was significantly reducing physical growth, neurological development and learning performance. There is limited data about the magnitude of iron deficiency anemia in Saudi Arabia in young children. This study aimed to assess the prevalence and determinants of iron deficiency anemia in children attending primary health care at the age of the school entry. Methods: This is a cross-sectional study including children at the age of school entry and they should be tested for detection of anemia after their parents sign an informed consent. Children with other types of anemia were excluded from this study. The minimal sample size is calculated using Raosoft calculator based on the equation for proportion estimation. Based on this proportion, at the confidence level of 95% and estimation error of 0.05 the initial sample size is calculated to be 384 participants. A questionnaire was used to collect data from the mothers or caregiver for the children. Results: A total sample of 384 attendants in PHC centers responded to the questionnaire, of them 59.5% were males. About 68% of the mothers have a high level of education as university or postgraduate studies and 83% were married. The prevalence of anemia was found to be 24% among children for both genders. Only nationality was a significant predictor for iron-deficiency anemia among children. Saudis children had a significantly lower prevalence of anemia than non-Saudis. Conclusions: The prevalence of anemia among children at age of school entry was high and more attention to the nutritional habits of children should be given by mothers and health specialists. Educational campaign should be conducted to increase awareness about proper children nutrition among women, particularly women with non-Saudi nationality.

The Impact of Iron Deficiency Anemia on Cerebrovascular Physiology, Brain Structure, and Cognitive Function in Otherwise Healthy Women

Introduction: Moderate iron deficiency anemia(IDA), defined as a hemoglobin below 11 g/dl, occurs in 1.5% of the United States population and is overrepresented in minority populations. IDA is known to cause permanent structural and function damage in children, but IDA's cognitive and neurovascular phenotype in adults is poorly characterized. We performed brain MRI and cognitive testing in 34 otherwise healthy women with IDA to determine whether oxygen delivery and metabolism are preserved as well as the association of IDA with brain volumes and cognitive function. Methods: We recruited potential blood donors from four hospital-based donor centers, Children's Hospital Los Angeles, University of California Los Angeles, Cedar's Sinai, and City of Hope, whose point-of-care hemoglobin values were less than 10.5 g/dl. We also recruited individuals from the community using social media advertisements, with anemia documented by screening hemoglobin assessment. All participants were free from inflammatory, infectious, or malignant diseases that may impact blood counts and iron metabolism. IDA was confirmed by laboratory assessment of CBC, reticulocyte count, iron indices, methyl malonic acid, hemoglobin electrophoresis, homocysteine, and high-sensitivity C-reactive protein. Patients underwent a four-hour neurocognitive assessment consisting of subsets from the Weschler Abbreviated Scale of Intelligence (WASI-II), the California Verbal Learning Test (CVLT), the Rey Complex Figure Test (RCFT), and the NIH Cognitive Toolkit. MRI was performed on a 3T Philips Achieva using a 32-element head coil. Anatomic imaging consisted of 3D T1, 3D T2, 3D T2*/QSM, and 2D multishell diffusion imaging. Phase contrast and arterial spin labeling measured total and regional brain blood flow, respectively. Cerebral venous oximetry was performed using T2 relaxation under spin tagging. Results: The study population demonstrated a classic IDA phenotype characterized by low ferritin and transferrin saturation, high iron binding capacity, decreased MCV and MCHC, and hypochromic microcytosis on blood smear (not shown). Neurocognitive function was impaired across multiple domains for women having hemoglobin values less than 10.0 g/dl (Figure 1, left), with Cohen's D values ranging from 0.7 - 1.5. Cerebral blood flow (CBF) rose slightly as oxygen content declined (Figure 1, right), but much less than predicted based on historical controls 1,2 leading to impaired brain oxygen delivery. Oxygen extraction fraction was independent of hemoglobin concentration, thus cerebral metabolic rate was also decreased. Grey matter volume was smaller in the right temporal lobe and correlated with 2/3 of the abnormal cognitive indices (in Figure 1, left). White matter volume was decreased in the right cingulate gyrus, corpus callosum, and cerebellum, correlating with the remaining abnormal cognitive indices. Discussion: Our study demonstrates that iron deficiency has serious effects on cognitive performance; individuals with hemoglobin less than 10.0 g/dl scored more than one standard deviation below their peers with milder anemia. Poor cognitive performance was correlated with demonstrable brain shrinkage whose reversibility is unknown. The failure of the brain to upregulate CBF in response to IDA was striking because most patients with chronic anemia preserve cerebral oxygen delivery through compensatory hyperemia 1,2. While both anemia and iron deficiency can impair brain function on their own, it is likely that iron deficiency is the primary contributor to the cognitive and neurovascular effects. We will test this hypothesis in subsequent work by reexamining women with IDA shortly after intravenous iron administration, thus creating a window where the iron deficiency has been corrected but the anemia persists(NCT05929729). We will also determine whether the cerebrovascular, anatomic, and functional deficits are reversible with iron repletion.

PB0202 The Impact of Iron Deficiency Anemia on Activation of Coagulation in Hereditary Hemorrhagic Telangiectaisa

PB0202 The Impact of Iron Deficiency Anemia on Activation of Coagulation in Hereditary Hemorrhagic Telangiectaisa

Effects of Iron Deficiency Anemia and its Treatment on Ghrelins, Obestatin and Heat Shock Protein 70

The impact of iron deficiency anemia (IDA) and its treatment on increased levels of heat shock protein 70 (HSP70) in settings with higher tissue stress induced by both ghrelin, which is both an antioxidant and a food intake stimulant, and also obestatin with opposing effects were investigated. The association of pica with these parameters was also examined. The study included 28 patients with IDA and 28 healthy controls. While acyl ve des-acyl ghrelin values were lower (p<0.05) in IDA. With treatment, ghrelin levels climbed. In IDA, obestatin levels were higher than the control values (p<0.05). With the IDA treatment, acyl and des-acyl Ghrelin levels increased. Contrarily, obestatin values fell down. The concentration of HSP 70 in IDA and during its therapy was above control values. Acyl, des-acyl ghrelin, obestatin, and HSP70 levels were increased in the pica group. In the pica group obestatin/acyl ghrelin ratio was comparatively higher (p<0.05). In IDA decrease in ghrelin and an increase in obestatin levels are observed, while HSP 70 remains the same. An increase in the obestatin/acyl ghrelin ratio might be responsible for the pica disorder.

Provision of FE Tablets to The Event of Anemia in Adolescent Women in The Area Community Health Center Technical Implementation Unit Liggang Bigung

Introduction: Adolescent girls will experience menstruation every month which at this time of menstruation they will be at risk of developing anemia. The impact of iron deficiency anemia includes lack of concentration in school-age adolescents which results in decreased school achievement, decreased work ability for workers so that their productivity is reduced. Objective: The purpose of this study was to see the effectiveness of giving Fe tablets to the incidence of anemia. Methods: Using a pre-experimental research design with control. The population in the study was 97 young women at Junior High School 01 Linggang Begung. Results: the results of the Wiloxcon test in the intervention group were obtained (p value 0.000<?<0.05). These results explain that there is a significant effect of the intervention on Hb levels with (p value < = 0.05). These results explain that there are differences in the intervention of Hb levels in the intervention and control groups with (p value < = 0.05). Discussion: Administration of Fe tablets can increase the erythropoiesis process which initiates the formation of mitotic unipotential stem cells while differentiation into erythrocyte cells when stimulated by erythropoietin also stimulates further mitosis of promonoblasts, basophilic normoblasts and polychromatophilic normoblasts. Conclusion: there was an increase of 1.95 g/dl in the intervention group and 0.15 g/dl in the control group. Where the administration of Fe tablets with a commitment to consuming Fe tablets can increase Hb levels for 1 month of administration

113. Impact of iron deficiency anemia on postoperative outcomes of thoracolumbar spinal fusion (≥2-level) on patients with adult spinal deformity with minimum two-year follow-up surveillance

BACKGROUND CONTEXT Iron deficiency anemia (IDA) is a common hematological disorder and cause of low hemoglobin. Preoperative anemia has been shown to increase the risk of adverse outcomes after posterior cervical fusion and other spinal surgery. The need for a transfusion during lumbar fusion has been shown to increase the length of stay. The impact of IDA on outcomes after spinal fusion for ASD is unknown. PURPOSE This study sought to compare outcomes and complication rates between ASD patients with and without IDA undergoing 2+ level spinal fusion. STUDY DESIGN/SETTING Retrospective review. PATIENT SAMPLE The New York State Statewide Planning and Research Cooperative System (NYS SPARCS) was queried from 2009-2011 to identify all patients undergoing 2+ level spinal fusion for ASD with two-year follow-up. OUTCOME MEASURES Two-year rates of medical and surgical complications as well as readmissions, reoperations and mortality. METHODS NY SPARCS was queried from 2009-11 to identify all patients undergoing 2-level thoracolumbar spinal fusion (primary and revision) for ASD with 2-year follow-up. Patients were then stratified by the presence (IDA) or absence (no-IDA) of IDA. IDA and no-IDA were 1:1 propensity score-matched based on age, sex and obesity. Univariate analysis compared demographics, hospital parameters, and rates of adverse outcomes. Multivariate binary logistic regression was used to identify independent predictors of adverse outcomes. RESULTS A total of 524 patients (262 IDA and 262 no-IDA) were identified. There was no difference in age (56.8 vs 56.8 years), sex (79.8% vs 79.8% female), or obesity (13.0% vs 13.0%), all p=1.0. IDA patients had higher hospital cost ($95, 673 vs $59,537) and LOS (6.0 vs 4.0 days), all p < 0.001. IDA patients experienced higher rates of overall surgical complications (50.4% vs 23.7%, p < 0.001), wound complications (3.4% vs 0.4%, p=0.011), and blood transfusion (10.3% vs 6.5%, p <0.001). There was no difference in the rate of overall medical complications. IDA and no-IDA had comparable rates of readmission (8.0% vs 13.0%, p=0.064), though IDA had lower rates of reoperation (7.6% vs 13.0%, p=0.044). There was no mortality in either cohort. IDA independently was associated with wound complications (OR=10.6, p=0.028), blood transfusion (OR=3.9, p <0.001), and surgical complications (OR=3.5, p <0.001). CONCLUSIONS Baseline IDA was predictive of increased wound complications, postoperative blood transfusion and overall surgical complications following ASD surgery. This data can be used to better optimize and risk-stratify patients prior to surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs. Iron deficiency anemia (IDA) is a common hematological disorder and cause of low hemoglobin. Preoperative anemia has been shown to increase the risk of adverse outcomes after posterior cervical fusion and other spinal surgery. The need for a transfusion during lumbar fusion has been shown to increase the length of stay. The impact of IDA on outcomes after spinal fusion for ASD is unknown. This study sought to compare outcomes and complication rates between ASD patients with and without IDA undergoing 2+ level spinal fusion. Retrospective review. The New York State Statewide Planning and Research Cooperative System (NYS SPARCS) was queried from 2009-2011 to identify all patients undergoing 2+ level spinal fusion for ASD with two-year follow-up. Two-year rates of medical and surgical complications as well as readmissions, reoperations and mortality. NY SPARCS was queried from 2009-11 to identify all patients undergoing 2-level thoracolumbar spinal fusion (primary and revision) for ASD with 2-year follow-up. Patients were then stratified by the presence (IDA) or absence (no-IDA) of IDA. IDA and no-IDA were 1:1 propensity score-matched based on age, sex and obesity. Univariate analysis compared demographics, hospital parameters, and rates of adverse outcomes. Multivariate binary logistic regression was used to identify independent predictors of adverse outcomes. A total of 524 patients (262 IDA and 262 no-IDA) were identified. There was no difference in age (56.8 vs 56.8 years), sex (79.8% vs 79.8% female), or obesity (13.0% vs 13.0%), all p=1.0. IDA patients had higher hospital cost ($95, 673 vs $59,537) and LOS (6.0 vs 4.0 days), all p < 0.001. IDA patients experienced higher rates of overall surgical complications (50.4% vs 23.7%, p < 0.001), wound complications (3.4% vs 0.4%, p=0.011), and blood transfusion (10.3% vs 6.5%, p <0.001). There was no difference in the rate of overall medical complications. IDA and no-IDA had comparable rates of readmission (8.0% vs 13.0%, p=0.064), though IDA had lower rates of reoperation (7.6% vs 13.0%, p=0.044). There was no mortality in either cohort. IDA independently was associated with wound complications (OR=10.6, p=0.028), blood transfusion (OR=3.9, p <0.001), and surgical complications (OR=3.5, p <0.001). Baseline IDA was predictive of increased wound complications, postoperative blood transfusion and overall surgical complications following ASD surgery. This data can be used to better optimize and risk-stratify patients prior to surgery.

Iron deficiency anemia and bleeding management in pediatric patients with Bernard-Soulier syndrome and Glanzmann Thrombasthenia: A single-institution analysis.

Frequent and severe bleeding events (SBE) in patients with inherited qualitative platelet disorders Bernard-Soulier Syndrome (BSS) and Glanzmann Thrombasthenia (GT) can lead to secondary iron deficiency anemia (IDA). SBE are primarily treated with platelet transfusions or recombinant activated factor VII (rFVIIa) infusions. The impact of IDA on bleeding management and disease outcomes is understudied. To evaluate bleeding management, outcomes, and any association with IDA in pediatric patients with BSS and GT. Retrospective chart-review of pediatric patients with BSS or GT followed at a single hemophilia treatment center between 2007 and 2019. We identified 14 patients with BSS (n = 2) or GT (n = 12). Patients received rFVIIa (7%), platelet transfusions (7%), or a combination of both (57%) for SBE. Eleven patients (79%) had IDA requiring oral and/or intravenous iron replacement and 50% required red blood cell transfusions. Due to recurrent SBE and refractory IDA, three patients (21%) received rFVIIa prophylaxis at 90μg/kilogram 2-3times/week for ≥15months. Patients initiated on rFVIIa prophylaxis had a median baseline hemoglobin of 9.8 g/dL (min-max: 8.0-10.7 g/dL) compared to 11.7 g/dL (8.4-13.8 g/dL) for patients treated on-demand. Following initiation of rFVIIa prophylaxis, median hemoglobin and ferritin increased by 1.3 g/dL (0.7-2.5 g/dL) and 14.6 ng/mL (0.2-42.9ng/mL), respectively, and bleeding rates were reduced by 7-78%. IDA is a known complication of recurrent bleeding events in individuals with inherited bleeding disorders. Routine monitoring for IDA may help improve bleeding management and reduce bleed burden in BSS/GT.

Iron Fortification through Universal Distribution of Double-Fortified Salt Can Increase Wages and Be Cost-Effective: An Ex-Ante Modeling Study in India

BackgroundThe alleviation of iron deficiency through iron supplementation has not effectively reduced anemia in India, mainly due to low compliance. Food fortification with iron is considered a viable alternative, and the provision of double-fortified salt (DFS; with iron and iodine) has been mandated in public health programs. Limited evidence exists on its benefit–cost ratio. ObjectiveIn this study we sought to estimate the economic benefit in terms of increased wages in relation to introduction of DFS in reduction of anemia and the cost of doing so. MethodsThe economic benefit of introducing DFS in India was derived using a series of mathematical, statistical, and econometric models using data from national surveys capturing earnings and dietary iron intake of the population. Anemia status was predicted from data on dietary intake, sanitation, and for women, menstrual losses. The impact of iron deficiency anemia (IDA) on wages was estimated using a Heckman Selection model and 2-stage least squares procedure. Benefit of DFS was estimated through increased wages attributed to anemia reduction compared with its cost. ResultsMen and women with IDA had lower wages (by 25.9%, 95% CI: 11.3, 38.1; and by 3.9%, 95% CI: 0.0, 7.7, respectively) than those without IDA. Additional iron intake through DFS was predicted to reduce prevalence of IDA (from 10.6% to 0.7% in men and 23.8% to 20.9% in women). The economic benefit–cost ratio of introducing DFS at a national level was estimated to be 4.2:1. ConclusionsIron fortification delivered through DFS under a universal program can improve wages and be sufficiently cost-effective for its implementation at scale in India.

Impact of iron deficiency anemia on quality of life in patients with ulcerative colitis

AbstractAdvances in the last two decades have resulted in better long‐term remissions in patients with ulcerative colitis (UC), which is defined as an idiopathic, chronic inflammatory disorder of the colonic mucosa. This better remission has not transformed into a better quality of life. Almost one‐third of these patients have mild to moderate anemia, which is one of the main factors leading to decreased quality of life; hence we aimed to determine the prevalence of iron deficiency anemia (IDA) in UC during remission and its impact on the quality of life in this subpopulation. In this prospective study, all consecutive patients of UC in remission for the last 3 months were evaluated for disease activity by Simple Clinical Colitis Activity Index (SCCAI), IDA by blood parameters and quality of life by Short Inflammatory Bowel Disease Questionnaire (SIBDQ). All patients with proven IDA were given oral iron supplements (Ferrous Ascorbate elemental iron 100 mg) for 3 months. Blood parameters, SCCAI, and SIBDQ scores were evaluated at the end of therapy to compare them before iron supplementation. Out of 125 patients of UC seen during the study period, 69 were in remission. IDA was seen in 34 patients (49.27%). Median pre‐intervention and postintervention quality of life scores—SIBDQ (4.9 [4.2‐5.8] vs 5.4 [5.0‐6.1]) and blood parameters [hemoglobin 10.7 (9.8‐11.4) g% vs 13.2 (12.8‐13.7) g%]—showed significant improvement after iron supplementation. Prevalence of IDA in UC during remission is common (49.27%). Oral iron supplementation improves the quality of life and anemia significantly without increasing disease activity in UC under remission.

Impact of iron deficiency anemia on HbA1c level in non-diabetic children

Background and objective: HbA1c has been endorsed by the American Diabetes Association and World Health Organization to diagnose and monitor diabetes mellitus. Its value is directly proportional to the blood glucose level. However, besides the blood glucose level, other factors like iron deficiency anemia can affect HbA1c level. We conducted this study to reveal the impact of iron deficiency anemia on HbA1c level and to assess whether HbA1c result changes after the correction of iron deficiency anemia. Methods: Twenty five non-diabetic children who were confirmed to have iron deficiency anemia were enrolled. HbA1c, hemoglobin, serum iron, and ferritin were measured and compared at baseline and post-correction of iron deficiency anemia with a three-month age-appropriate dose of iron therapy. The baseline results were compared with 25 age- and sex-matched normal controls. Results: Children with iron deficiency anemia had significantly higher HbA1c level (6.144±0.6312, P &lt;0.001) than the control group (5.032±0.5558, P &lt;0.001). After three months of treatment of iron deficiency anemia, HbA1c significantly dropped (from 6.144±0.6312, P &lt;0.001 to 5.604±0.51, P &lt;0.001). Conclusion: This study concluded that HbA1c is inversely proportional to iron deficiency anemia in non-diabetic children, and treatment of iron deficiency anemia led to a drop in HbA1c level. Due to this false elevation of HbA1c by iron deficiency anemia, iron deficiency anemia should be considered and excluded before making the diagnosis or deciding on any therapeutic change in diabetic children. Keywords: Iron deficiency anemia; HbA1c; Non-diabetic children.

How Does Iron Deficiency Anemia Impact Outcomes following Revision Total Hip Arthroplasty?

PurposeStudies have shown the prevalence of iron deficiency anemia (IDA) increasing worldwide, and currently the literature is limited on the impact of IDA on outcomes following revision total hip arthroplasty (RTHA). Therefore, the purpose of this study was to determine whether IDA patients undergoing RTHA have longer: 1) in-hospital lengths of stay (LOS); 2) medical complications; and 3) costs of care.Materials and MethodsA retrospective query of a nationwide administrative claims database was performed. Using Boolean command operations, the study group consisted of all patients in the database undergoing RTHA with IDA; whereas, patients without IDA served as controls. To reduce the effects of confounding, study group patients were matched to controls in a 1:5 ratio by age, sex, and medical comorbidities yielding 92,948 patients with (n=15,508) and without (n=77,440) IDA undergoing revision THA. A P-value less than 0.001 was considered statistically significant.ResultsIDA patients were found to have significantly longer in-hospital LOS (5 days vs. 4 days, P<0.0001). Additionally, the study showed IDA patients were found to higher incidence and odds of (73.84% vs. 11.77%, OR 5.04, P<0.0001) 90-day medical complications. IDA patients also incurred high 90-day episode of care costs ($25,597.51 vs. $20,085.70, P<0.0001).ConclusionAfter adjusting for age, sex, and medical comorbidities this study of over 92,000 patients demonstrated IDA is associated with longer in-hospital LOS, complications, and costs of care. Future studies should compare the duration and severity of IDA on outcomes.

Impact of Iron Deficiency Anemia on Inpatient Mortality, Hospital Cost, and Length of Stay in Patients with Luminal Gastrointestinal Cancers: Data from the Healthcare Cost and Utilization Project from 1999-2014

Background: Anemia frequently complicates the course of cancer, varying widely depending on the cancer type and stage. Iron deficiency anemia (IDA), specifically, can develop in nearly half of this population1. The impact of iron deficiency anemia on prognosis in cancer patients is largely unknown. We endeavored to evaluate trends in the prevalence of IDA in relation to inpatient mortality, costs of hospitalization, and length of stay in patients admitted with luminal gastrointestinal cancers (esophageal, gastric, small intestine, and colorectal cancers for the purpose of this study).Methods: We analyzed data from the Healthcare Cost and Utilization Project's (HCUP) National Inpatient Sample, between 1999 and 2014 using the ICD-9 codes for esophageal cancer (150), gastric cancer (151), small intestinal cancer (152.9, 209.0), and colorectal cancer (153.0, 153.1, 153.2, 153.3, 153.4, 153.6, 153.7, 153.8, 153.9, 154.0, 154.1) in the primary diagnosis field. The subset of these numbers with IDA (280.9) listed as a secondary diagnosis were recorded to derive a prevalence of iron deficiency anemia within this luminal gastrointestinal cancer population. The prevalence of iron deficiency anemia, inpatient mortality, total hospital cost, and length of stay (LOS) were compared among the luminal gastrointestinal cancers.Results: A total of 588,142 (weighted N=2,896,663) admissions with a primary luminal gastrointestinal cancer diagnosis were identified from 1999-2014. A total of 30,566 (weighted N=150,961) admissions were associated iron deficiency anemia. A total of 557,576 (weighted N=2,746,257) admissions were not associated with anemia.In patients with esophageal cancer and IDA, inpatient mortality was higher at 11.5%, compared to 4.7% in those without IDA (p< 0.0001). Overall hospital cost was higher at $64,140 (± 564) versus $52,692 (± 2430) (p< 0.0001). IDA was also associated with an increase in length of stay at 9.7 days compared to 8.9 days, though not significantly (p= 0.06). In gastric cancer patients with concurrent IDA, inpatient mortality was higher at 9.1% as compared to 3.8% in those without IDA (p< 0.0001). The total charges were higher with IDA: $66,179 (± 361) vs. $59,745 (± 1325) (p< 0.0001). Gastric cancer patients with IDA also had a longer length of stay of 10.3 days in comparison to 9.4 days in those without IDA (p=0.05).Similar trends were noted in small intestinal cancer with concomitant IDA; higher inpatient mortality, 4.5% vs. 3% (p<0.0001), higher hospital costs, $68,699 (± 4874) vs. $65,890 (± 1883) (p<0.0001) and longer length of stay, 9.6 days vs. 8.8 days (p=0.05). IDA also had significant impact on all the three variables in patients with colorectal cancer; inpatient mortality, hospital costs and length of stay were higher 4.5% vs. 2.3% (p< 0.0001), $55,753 (± 367) vs. $49,466 (± 932) (p< 0.0001), and 9.1 days vs. 8.6 days (p=0.05) respectively.Conclusions: With cancer imminently emerging as the number one cause of death in the United States, cancer-related comorbidities have an unequivocal effect on disease prognosis. IDA is a commonly found and well recognized complication of luminal gastrointestinal cancers. Notwithstanding the limitations of a billing code based retrospective study, we observed that in patients with luminal gastrointestinal cancers associated with iron deficiency anemia, inpatient mortality was significantly higher compared to those without IDA. Hospital costs and length of stay likewise, were higher in patients with a luminal gastrointestinal cancer and IDA. We hypothesize that iron deficiency anemia is an independent prognostic factor that has direct impact on mortality and as an extension, morbidity in patients with luminal gastrointestinal cancers. Open for future exploration with prospective studies are the impacts of iron deficiency anemia on cancer-related overall survival and not just inpatient mortality, and the effect of early identification and treatment of IDA on survival and health care costs. DisclosuresNo relevant conflicts of interest to declare.

Evaluation of the Impact of Iron Deficiency Anemia during Pregnancy on Hospital Admission and Utilization of Hospital Resources in Latifa Women and Children Hospital, Dubai, UAE

Introduction: Iron deficiency anemia (IDA) is endemic among pregnant females worldwide. Liposomal iron preparation is a novel therapy for treating IDA in pregnant females. There is a lack of research on cost-effect and comparison between various new iron preparations as liposomal and intravenous (IV) iron supplements in the international literature. Objective: The objective of this study was to evaluate the cost-effect and maternal-fetal outcome of IDA during pregnancy in Latifa Women and Children Hospital, Dubai, UAE. Design: The study was a quasi-experimental study. Settings: Settings include tertiary-care hospital settings affiliated with academic center in UAE. Patients and Methods: A total of 226 pregnant women were inducted in the study who were controlled in terms of age, BMI, baseline hemoglobin (Hb), severity of anemia, and ferritin levels. There were 116 patients who received oral liposomal iron pyrophosphate and 110 patients received IV iron saccharate complex for 4 weeks. The overall cost-effect and maternal-fetal outcomes were compared in 2 groups. Main Outcomes Measured: The main outcomes measured the cost-effect of liposomal and IV iron therapy, and the 2 treatments were compared in terms of maternal and fetal outcomes. Result: The subjects were matched for age and body mass index and showed that the patients in the IV group were more symptomatic than those in the oral group (18.1 vs. 31.9% p value <0.01). There was no statistically significant difference among women from different nationalities living in UAE (p value 0.079). There were 98 (84.4%) patients in the oral group and 99 (90%) patients in the IV group who achieved the desired Hb levels after 1 month of treatment (p value = 0.878). Moreover, the side effects were also comparable in both groups (1.72 vs. 1.82% p value = 0.56). The incremental cost-effect ratio for IV iron was USD 108,633/rise to desired Hb. Conclusion: Liposomal iron preparations may be cost-effective and have fewer side effects than IV iron. In terms of outcome, the maternal and fetal variables are comparable in liposomal and IV groups.