Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study
Objectives To describe all iron deficiency anaemia (IDA)–related causes during follow-up of patients newly diagnosed with IDA and to assess whether a delayed colorectal cancer (CRC) diagnosis influences survival.Design and setting Retrospective cohort study of patients from general practices in the...
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BMJ Publishing Group
2019-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/11/e032930.full |
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| author | Patrick J E Bindels Joost van Rosmalen Annemarie Schop Karlijn Stouten Jurgen Riedl Ron van Houten Frank Wolfhagen Mark-David Levin |
| author_facet | Patrick J E Bindels Joost van Rosmalen Annemarie Schop Karlijn Stouten Jurgen Riedl Ron van Houten Frank Wolfhagen Mark-David Levin |
| author_sort | Patrick J E Bindels |
| collection | DOAJ |
| description | Objectives To describe all iron deficiency anaemia (IDA)–related causes during follow-up of patients newly diagnosed with IDA and to assess whether a delayed colorectal cancer (CRC) diagnosis influences survival.Design and setting Retrospective cohort study of patients from general practices in the Dordrecht area, the Netherlands.Participants Men and women aged ≥50 years with a new diagnosis of IDA (ie, no anaemia 2 years previously).Method From February 2007 to February 2018, all relevant data were collected from the files of the referral hospital. Early IDA-related cause was defined as established within 18 weeks after IDA diagnosis. Cox proportional-hazards regression was used to analyse survival of patients with CRC diagnosis.Results 587 patients with IDA were included with a median follow-up of 4.6 years. Early and late IDA-related causes could be established in 32% and 8% of patients, respectively. Early and late CRC was found in 8% and 2% of patients, respectively, and were located mainly right sided. After adjustment for age, gender and TNM classification, mortality risk was lower in patients with IDA with early CRC diagnosis, but not significantly (HR 0.30, 95% CI 0.09 to 1.02).Conclusion Even with extended follow-up, the cause of IDA remains elusive in the majority of patients with IDA in general practice. However, patients with IDA are at increased risk for in particular right-sided CRC and a late diagnosis of CRC appears to have a detrimental effect on survival in patients with IDA. |
| format | Article |
| id | doaj-art-588e36a945a34a3a886620e2d5dffa9f |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-588e36a945a34a3a886620e2d5dffa9f2024-11-30T04:20:11ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-032930Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort studyPatrick J E Bindels0Joost van Rosmalen1Annemarie Schop2Karlijn Stouten3Jurgen Riedl4Ron van Houten5Frank Wolfhagen6Mark-David Levin7Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands4 Biostatistics, Erasmus MC, Rotterdam, The Netherlands1 Internal Medicine, Albert Schweitzer Hospital Location Dordwijk, Dordrecht, The Netherlands2 Clinical Chemistry, Albert Schweitzer Hospital Location Dordwijk, Dordrecht, The Netherlands2 Clinical Chemistry, Albert Schweitzer Hospital Location Dordwijk, Dordrecht, The Netherlands3 General practice, General practice van Houten, Hendrik-Ido-Ambacht, The Netherlands5 Gastro-enterology, Albert Schweitzer Hospital Location Dordwijk, Dordrecht, The NetherlandsDepartment of Internal Medicine, Albert Schweitzer Hospital Location Dordwijk, Dordrecht, Zuid-Holland, The NetherlandsObjectives To describe all iron deficiency anaemia (IDA)–related causes during follow-up of patients newly diagnosed with IDA and to assess whether a delayed colorectal cancer (CRC) diagnosis influences survival.Design and setting Retrospective cohort study of patients from general practices in the Dordrecht area, the Netherlands.Participants Men and women aged ≥50 years with a new diagnosis of IDA (ie, no anaemia 2 years previously).Method From February 2007 to February 2018, all relevant data were collected from the files of the referral hospital. Early IDA-related cause was defined as established within 18 weeks after IDA diagnosis. Cox proportional-hazards regression was used to analyse survival of patients with CRC diagnosis.Results 587 patients with IDA were included with a median follow-up of 4.6 years. Early and late IDA-related causes could be established in 32% and 8% of patients, respectively. Early and late CRC was found in 8% and 2% of patients, respectively, and were located mainly right sided. After adjustment for age, gender and TNM classification, mortality risk was lower in patients with IDA with early CRC diagnosis, but not significantly (HR 0.30, 95% CI 0.09 to 1.02).Conclusion Even with extended follow-up, the cause of IDA remains elusive in the majority of patients with IDA in general practice. However, patients with IDA are at increased risk for in particular right-sided CRC and a late diagnosis of CRC appears to have a detrimental effect on survival in patients with IDA.https://bmjopen.bmj.com/content/9/11/e032930.full |
| spellingShingle | Patrick J E Bindels Joost van Rosmalen Annemarie Schop Karlijn Stouten Jurgen Riedl Ron van Houten Frank Wolfhagen Mark-David Levin Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study BMJ Open |
| title | Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study |
| title_full | Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study |
| title_fullStr | Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study |
| title_full_unstemmed | Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study |
| title_short | Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study |
| title_sort | long term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice a retrospective cohort study |
| url | https://bmjopen.bmj.com/content/9/11/e032930.full |
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