Treating iron deficiency in patients with gastrointestinal disease: Risk of re-attendance in secondary care

Tomkins, Susannah; Chapman, C.; Myland, Melissa; Tham, Rachel; Nobrega, Rachael de; Jackson, Brinley; Keshav, Satish

doi:10.1371/journal.pone.0189952

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…While cost‐effectiveness was not an endpoint of this study, a recently published cohort study of patients with gastrointestinal disease and IDA suggested a potential advantage of iv over oral iron in terms of healthcare utilisation due to lower risk of hospital re‐attendance and shorter length of stay . Our study showing rapid correction of both anaemia and iron deficiency among FCM‐treated patients with Hb levels <10 g/dL can support the identification of a feasible cut‐off when to prefer iv over oral iron in patients with gastrointestinal disease.…”

Section: Discussionmentioning

confidence: 56%

Randomised clinical trial: intravenous vs oral iron for the treatment of anaemia after acute gastrointestinal bleeding

Ferrer-Barceló

Artero

García-Argüelles

et al. 2019

Aliment Pharmacol Ther

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Summary Background Acute gastrointestinal bleeding is prevalent condition and iron deficiency anaemia is a common comorbidity, yet anaemia treatment guidelines for affected patients are lacking. Aim To compare efficacy and safety of intravenous ferric carboxymaltose (FCM) and oral ferrous sulphate (FeSulf) in patients with anaemia secondary to non‐variceal gastrointestinal bleeding Methods A prospective 42‐day study randomised 61 patients with haemoglobin <10 g/dL upon discharge (Day 0) to receive FCM (n = 29; Day 0: 1000 mg, Day 7: 500 or 1000 mg; per label) or FeSulf (n = 32; 325 mg/12 hours for 6 weeks). Outcome measures were assessed on Days 0 (baseline), 7, 21 and 42. The primary outcome was complete response (haemoglobin ≥12 g/dL [women], ≥13 g/dL [men]) after 6 weeks. Results A higher proportion of complete response was observed in the FCM vs the FeSulf group at Days 21 (85.7% vs 45.2%; P = 0.001) and 42 (100% vs 61.3%; P < 0.001). Additionally, the percentage of patients with partial response (haemoglobin increment ≥2 g/dL from baseline) was significantly higher in the FCM vs the FeSulf group (Day 21:100% vs 67.7%; P = 0.001, Day 42:100% vs 74.2%; P = 0.003). At Day 42, normalisation of transferrin saturation to 25% or greater was observed in 76.9% of FCM vs 24.1% of FeSulf‐treated patients (P < 0.001). No patient in the FCM group reported any adverse event vs 10 patients in the FeSulf group. Conclusion FCM provided greater and faster Hb increase and iron repletion, and was better tolerated than FeSulf in patients with iron deficiency anaemia secondary to non‐variceal acute gastrointestinal bleeding.

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Section: Discussionmentioning

confidence: 56%

Randomised clinical trial: intravenous vs oral iron for the treatment of anaemia after acute gastrointestinal bleeding

Ferrer-Barceló

Artero

García-Argüelles

et al. 2019

Aliment Pharmacol Ther

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“…Although the impact of anemia on disease prognosis has not been evaluated in this specific population, anemia has been shown to increase all‐cause mortality in hospitalized cats 10 . Furthermore, anemia directly increases morbidity associated with GI disease in humans 6,29 . Not all cats with FID in our study were anemic.…”

Section: Discussionmentioning

confidence: 78%

“…10 Furthermore, anemia directly increases morbidity associated with GI disease in humans. 6,29 Not all cats with FID in our study were anemic. This finding is similar to what is observed in humans, in whom iron deficiency is diagnosed in 80% to 90% of people with chronic GI disease, with or without concurrent anemia, 1 and disease activity is independently related to iron deficiency in some forms of disease.…”

Section: Discussionmentioning

confidence: 95%

Anemia, iron deficiency, and cobalamin deficiency in cats with chronic gastrointestinal disease

Hunt

Jugan

2020

Veterinary Internal Medicne

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Background Iron deficiency and cobalamin deficiency, as sequelae to chronic gastrointestinal (GI) disease, could result in anemia and increased morbidity in cats with chronic enteropathies. Objective To evaluate iron deficiency in cats with chronic GI disease and its relationship with hypocobalaminemia, anemia, and disease severity. Animals Twenty client‐owned cats with primary GI disease. Methods Prospective, cross‐sectional study. Cats were enrolled at the time of evaluation for chronic GI disease, after exclusion of comorbidities. CBC with reticulocyte indices, iron metabolism (serum iron and ferritin concentrations, total iron binding capacity [TIBC]), serum methylmalonic acid (MMA), cobalamin, and folate concentrations, pancreatic lipase and trypsin‐like immunoreactivity, and disease severity were evaluated. Results Anemia (hematocrit <30%), iron deficiency, and cobalamin deficiency were diagnosed in 4/20, 7/20, and 8/20 cats, respectively. Hematocrit (rs = −.45; P < .05) and body condition score (rs = −.60; P < .01) negatively correlated with MMA. Median TIBC was lower in cats with increased vs normal MMA (218 μg/mL; range, 120‐466 μg/mL vs 288 μg/mL; range, 195‐369 μg/mL; P = .02). Hematocrit (rs = .51; P = .02), reticulocyte MCV (rs = .52; P = .02), reticulocyte hemoglobin content (rs = .71; P < .001), and percent transferrin saturation (rs = .79; P < .0001) positively correlated with serum iron concentration. Conclusions and Clinical Importance Functional iron deficiency was common in cats with chronic GI disease. Associations between hypocobalaminemia, iron parameters, and hematologic parameters warrant further investigation on the impact of iron deficiency on chronic GI disease morbidity in cats.

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“…Most patients with gastrointestinal tumors have different negative emotions, such as fear, anxiety, and depression due to the disease itself and surgically invasive treatment; thus, the self-efficacy is poor. Such factors can harm the rehabilitation of the disease[ 16 - 19 ]. Therefore, this study implemented self-efficacy education for patients with gastrointestinal tumors during the intervention period.…”

Section: Discussionmentioning

confidence: 99%

Effects of cooperative nursing and patient education on postoperative infection and self-efficacy in gastrointestinal tumors

Li¹,

Zeng²,

Zhang³

2021

WJCC

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BACKGROUND Gastrointestinal tumors have a high incidence rate. The application value of the cooperative nursing care system of medical care has received widespread attention in recent years. However, there are few studies on the value of the joint application of collaborative nursing care and self-efficacy education. AIM To explore the effect of cooperative nursing care management/self-efficacy education on postoperative infection and self-efficacy in gastrointestinal tumor surgery patients. METHODS A total of 102 patients with gastrointestinal tumors treated in our hospital from October 2018 to February 2020 were selected and divided into a conventional group ( n = 51) and a combined group ( n = 51) according to the nursing plan. The routine group adopted routine nursing, and the joint group adopted the medical care cooperative responsibility system nursing management combined with self-efficacy education. The self-efficacy scores, coping style scores, self-experience burden scores, and postoperative complication rates of the two groups before and after intervention were counted. RESULTS After intervention, the daily life behavior management, cognitive symptom management, and disease management scores of the two groups were higher than those before the intervention, and those of the combined group were higher than those of the conventional group (all P = 0.000). After the intervention, the positive response scores of the two groups were higher than those before the intervention, the negative response scores were lower than those before the intervention, and the combined group was better than the conventional group (all P = 0.000). After the intervention, the two groups’ emotional, economic, and physical factor scores were lower than those before the intervention, and the combined group was lower than the conventional group (all P = 0.000). The incidence of infection in the combined group (1.96%) was lower than that in the conventional group (15.69%) ( P = 0.036). CONCLUSION Cooperative nursing care management and self-efficacy education improved the physical and mental states of gastrointestinal cancer surgery patients, change the response to disease, and reduce the risk of postoperative infection.

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Treating iron deficiency in patients with gastrointestinal disease: Risk of re-attendance in secondary care

Cited by 9 publications

References 27 publications

Randomised clinical trial: intravenous vs oral iron for the treatment of anaemia after acute gastrointestinal bleeding

Randomised clinical trial: intravenous vs oral iron for the treatment of anaemia after acute gastrointestinal bleeding

Anemia, iron deficiency, and cobalamin deficiency in cats with chronic gastrointestinal disease

Effects of cooperative nursing and patient education on postoperative infection and self-efficacy in gastrointestinal tumors

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