Iron Status Assessment among Hospitalized Patients with Acute Upper Gastrointestinal Bleeding

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Tatsanai Sattayaraksa
Natthawat Sitthinamsuwan
Nuttanit Pungpipattrakul
Kittiphan Chienwichai
Tiprada Jari
Keerati Akarapatima
Attapon Rattanasupar
Arunchai Chang


BACKGROUND: Data on iron status assessment and iron deficiency anemia (IDA) prevalence in acute upper gastrointestinal bleeding (UGIB) are limited.

OBJECTIVES: In this study, we aimed to investigate iron status assessment and prevalence of IDA and its associated factors in patients with anemia hospitalized for acute UGIB.

METHODS: We retrospectively reviewed the medical records of patients with endoscopically confirmed UGIB who were admitted between January 2016 and December 2019 and presented with anemia upon admission. The outcomes were iron status measurement and IDA incidence. A logistic regression model was used to determine the factors affecting outcomes.

RESULTS: Among the 867 patients, 180 (20.8%) were evaluated for iron status. Of these patients, 108 (60.0%) had IDA. Factors of iron status assessment were ischemic heart disease (adjusted odds ratio [aOR] 3.88, p=0.001), non-steroidal anti-inflammatory drug use (aOR 1.56, p=0.03), traditional medicine use (aOR 2.84; p=0.01), and mean corpuscular volume (MCV) <80 fL (aOR 1.52, p=0.03), however, older age (aOR increased 0.984 for every 1 year; p=0.01), variceal bleeding (aOR 0.14; p<0.001) and AIMS65 score >2 (aOR 0.69, p=0.002) were intervening factors for iron status assessment. Female sex (aOR 2.69, p=0.05) and MCV <80 fL (aOR 2.00, p=0.04) were independent risk factors for IDA, but diabetes mellitus was a protective factor for IDA (aOR 0.32, p=0.001).

CONCLUSIONS: Iron status assessment among patients with acute UGIB and anemia was low, while the incidence of IDA was high. Our results indicate the importance of evaluating iron status and factors associated with IDA to improve the management of anemia secondary to acute UGIB. Identifier, NCT06299007

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Original Article


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