Clinical StudiesUpper and lower gastrointestinal evaluation of elderly inpatients who are iron deficient
Section snippets
Patients and methods
All patients older than 70 years with iron deficiency who were admitted to the acute geriatric ward during a 30-month study period were prospectively enrolled. None of these patients participated in our previous study (12). All patients were screened with a serum ferritin level at admission. Although the iron content of a bone marrow is the reference standard, a low serum ferritin level is a good indicator of depleted iron stores. There is no agreement on the lower limit of normal, but based on
Results
Of the 3,178 elderly patients who were admitted to the geriatric ward during the study period, 267 (8.4%) had two serum ferritin levels <50 μg/L and fulfilled the inclusion criteria. A gastrointestinal investigation was impractical in 19 patients because of poor general condition (terminal illness, coma) or because they died within the first days after admission. Of the remaining 248 patients who underwent an upper gastrointestinal endoscopy, 97 (39%) were subsequently excluded from the final
Discussion
The main aim of the present study was to investigate the prevalence of gastrointestinal lesions with a potential for bleeding in elderly patients admitted to a geriatric hospital. The patients were selected on the basis of a low serum ferritin level on admission. With few exceptions, previous studies that have addressed the efficacy of gastrointestinal investigation in patients with iron deficiency excluded patients who were not anemic 3, 4, 5, 6, 7, 8, 9, 10, 11, 14, 15. Our working hypothesis
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Cited by (98)
A comprehensive evaluation of the gastrointestinal tract in iron-deficiency anemia with predefined hemoglobin below 9 mg/dL: A prospective cohort study
2017, Digestive and Liver DiseaseCitation Excerpt :Although GI cancer should be considered in these subjects, blood loss is most often caused by erosive and ulcerative lesions of the upper GI tract [1–6]. Studies aimed at establishing the diagnostic usefulness of a comprehensive GI evaluation in IDA usually include patients with hemoglobin levels just below the lower limits of normal [7–16], according to recommended cutoffs defining anemia (i.e. hemoglobin <13 and <12 g/dL in men and nonpregnant women, respectively) [17,18]. Some leading guidelines do not propose a specific hemoglobin threshold for urgent investigation of IDA but advise investigation of any level of anemia in iron deficiency [4], recommending quicker examination in older subjects to rule out colorectal cancer [19].
Evaluation of iron deficiency anaemia for gastrointestinal causes in patients without GI symptoms in high prevalent GI malignancy zones
2016, Arab Journal of GastroenterologyCitation Excerpt :All females exhibiting malignancy were postmenopausal, which is consistent with the findings in other studies [17,20–25]. All of the malignancies in our study were adenocarcinomas, in accordance with other studies [2,13,16,17,20,26]. The other nonmalignant lesions in our study that could significantly contribute to IDA are more or less similar to other studies.
Role of nutrition on anemia in elderly
2016, Clinical Nutrition ESPENThe red cell diameter width distribution, the forgotten haematological parameter for anaemia in the older person
2013, European Geriatric MedicineCitation Excerpt :Serum ferritin is still the best single test for the diagnosis of iron deficiency because its serum concentration is proportional to total body iron stores [11]. Indeed, the likelihood of finding significant gastrointestinal pathology in the older person with iron deficiency is similar in those without anaemia to those with anaemia [12]. Ferritin has a tendency to rise with age [13] and is an acute phase protein, which rises in chronic inflammatory disorders and in malignancy [14] and therefore its lower reference value should be redefined at 50 μg/l in the older person [15].
Anemia of geriatric patients
2022, Physiology InternationalNew horizons in iron deficiency anaemia in older adults
2020, Age and Ageing