| Title | Long-term Follow-up and Predictive Factors of Recurrence of Anemia in a Cohort of 102 Very Elderly Patients Explored for Iron-deficiency Anemia. | | Author(s) | Nahon S, Lahmek P, Barclay F, Macaigne G, Poupardin C, Jounnaud V, Delas N, Lesgourgues B | | Institution | *Service d'hépatogastroentérologie daggerDépartement d'information médicale, Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil double daggerService d'hépato-gastroentérologie, Centre Hospitalier de Lagny, France. | | Source | J Clin Gastroenterol 2008 Jun 25. | | Abstract | AIM: To evaluate long-term follow-up and predictors of relapse of anemia in a cohort of 102 very elderly patients previously explored for iron-deficiency anemia (IDA).
METHODS: One hundred and two patients [61 women and 41 men, mean age 82+/-5.8 y (75 to 98)] explored for IDA were prospectively followed up from inclusion (June 2003 to May 2005) until death or May 2006. Survival rate was estimated by the Kaplan-Meier method and compared by the log-rank test. Predictors of recurrence of anemia were identified by multivariate analysis in the 4 following subgroups: unexplained IDA (subgroup 1, n=27), benign lesion (subgroup 2, n=37), cancer treated curatively (subgroup 3, n=28), cancers treated palliatively (subgroup 4, n=10).
RESULTS: Median follow-up was 20 months. At baseline, main clinical and laboratory data were not significantly different in the 4 subgroups, especially as regards severe comorbidities. Thirty-three patients died, 10 (30%) of them in the first month. Ten (100%) belonged to subgroup 4 versus, respectively, n=7 (26%), n=8 (22%), and n=8 (29%) of patients from subgroups 1, 2, and 3 (P<0.001). No death was directly related to recurrence of anemia. Survival rate at 1 year was 10% in subgroup 4, significantly lower than the other 3 subgroups (subgroup 1: 84%; subgroup 2: 86%; subgroup 3: 78%; log-rank test, P<0.0001). Anemia recurred in 18 cases, and required red cell transfusion in 13 cases. Predictive factors of recurrence of anemia [odds ratio (confidence interval 95%), P] were cancers treated palliatively [14.9 (3-72), P<0.01] and angiodysplasias [4.5 (1.1-18.2), 0.035].
CONCLUSIONS: In a cohort of very elderly patients explored for IDA, the mortality rate and the long-term survival were not different for patients with IDA related to a cancer treated curatively than those with unexplained IDA and those with IDA related to a benign lesion. Angiodysplasias and cancers treated palliatively were associated with recurrence of anemia. These results suggest interventionist strategies (including endoscopic investigation and appropriate surgery) for elderly patients with IDA. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 18596538 |
|
