Dr Stephane Nahon and colleagues identified predictors of relapse of anemia in a cohort of 102 very elderly patients previously explored for iron-deficiency anemia.
The team followed up 102 patients for iron-deficiency anemia from inclusion in 2003 until death or 2006.
|The survival rate at 1 year was 10%|
|Journal of Clinical Gastroenterology|
Survival rate was estimated by the Kaplan-Meier method and compared by the log-rank test.
The team identified predictors of recurrence of anemia by multivariate analysis in 4 groups.
The researchers included 27 subjects with unexplained iron-deficiency anemia in Group 1, and 37 with benign lesions in Group 2.
The team included 28 patients in Group 3 with cancer treated curatively, and 10 with cancers treated palliatively in Group 4.
The researchers reported that the median follow-up was 20 months.
At baseline, main clinical and laboratory data were not significantly different in the 4 groups, especially regarding severe comorbidities.
The team noted that 33 patients died, 10 of them in the first month.
Most of these patients had cancers treated palliatively.
The team found no death was directly related to recurrence of anemia.
Survival rates at 1 year was 10% in Group 4, significantly lower than the other 3 groups.
Anemia recurred in 18 cases, and required red cell transfusion in 13 cases.
Predictive factors of recurrence of anemia were cancers treated palliatively and angiodysplasias.
Dr Nahon’s team concluded, “In a cohort of very elderly patients explored for iron-deficiency anemia, the mortality rate and the long-term survival were not different for patients with iron-deficiency anemia related to a cancer treated curatively than those with unexplained iron-deficiency anemia.”
“Those with iron-deficiency anemia 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 iron-deficiency anemia.”