Document Detail


Management and predictors of early mortality in elderly patients with iron deficiency anemia: a prospective study of 111 patients.
MedLine Citation:
PMID:  17347626     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Iron deficiency anemia (IDA) is common in the elderly. It usually results from gastrointestinal (GI) bleeding and requires endoscopic exploration of the gastrointestinal tract. The aim of this prospective study in elderly patients was to evaluate the feasibility of endoscopy, the therapeutic impact, and identify predictors of early mortality. METHODS: From June 2003 to May 2005, all patients over 75 years, hospitalized for anemia were screened for iron deficiency. Clinical (including serious comorbidities), biological, endoscopic and therapeutic data were collected. One month after treatment, a follow-up was carried out to assess the tolerance of such investigation and treatment. RESULTS: One hundred and eleven patients (69 women, 82.3 +/- 6.4 years) had IDA, 102 (92%) underwent an upper endoscopy and 91 (82%) a colonoscopy. Nine (8%) patients were not investigated because of poor clinical condition (N=4) or dementia (N=5). Of the 75 (68%) patients with an identified source of bleeding, 12 (11%) had a synchronous lesion, 43 (39%) a colorectal source including 31 (72%) colorectal cancer, and 44 (40%) an upper GI source. Sixty-nine (92%) of the 75 patients received at least one of the following treatments: medical (N=27), endoscopic (N=20), and surgical (N=31). Surgery was curative in 28/31 (90%) cases of which 25/27 were colorectal cancers. One month after treatment, overall mortality was 11/111 (10%) and 4/31 (13%) after surgery. Predictors of early mortality (Odd ratio, 95% Confidence Interval) were: a malign cause (42; 3-588), no specific treatment (34; 3-423), at least 2 co-morbidities (20; 1-400). CONCLUSION: In an unselected hospitalized population of elderly patients with IDA, endoscopy was generally feasible, allowing identification of a source of bleeding, especially colorectal cancer. A specific treatment was usually possible and proved curative without increase in early mortality.
Authors:
Stéphane Nahon; Pierre Lahmek; Nazmye Aras; Cécile Poupardin; Bruno Lesgourgues; Gilles Macaigne; Nicolas Delas
Related Documents :
21160846 - Natural history of intraductal papillary mucinous neoplasia: how much do we really know?
21416246 - The management of hospitalized patients with cirrhosis: the mount sinai experience and ...
21167736 - Reoperative orthognathic surgery.
21400436 - Hysteroscopy: techniques, technology, and controversies.
1557336 - Treatment of acute pancreatitis caused by calculous obstruction of the pancreatic duct ...
7427066 - The place of isolated rectal excision in the treatment of ulcerative colitis.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastroentérologie clinique et biologique     Volume:  31     ISSN:  0399-8320     ISO Abbreviation:  Gastroenterol. Clin. Biol.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-03-09     Completed Date:  2007-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704825     Medline TA:  Gastroenterol Clin Biol     Country:  France    
Other Details:
Languages:  eng     Pagination:  169-74     Citation Subset:  IM    
Affiliation:
Service d'Hépato-Gastroentérologie, Centre Hospitalier Intercommunal Le Raincy-Montfermeil. snahon@ch-montfermeil.fr
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Anemia, Iron-Deficiency / etiology,  mortality*,  therapy
Comorbidity
Endoscopy, Digestive System
Feasibility Studies
Female
France / epidemiology
Gastrointestinal Diseases / complications,  diagnosis
Humans
Male
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  An uncommon perianal nodule: hidradenoma papilliferum.
Next Document:  Satisfaction of patients treated for chronic hepatitis C with the peginterferon alfa-2b pen device: ...