Opportunistic screening for iron-deficiency in 6-36 month old children presenting to the Paediatric Emergency Department.
BACKGROUND
The Complete Blood Count (CBC) is a test frequently performed on children presenting to the Pediatric Emergency Department (PED), usually for the evaluation of an infectious illness. The CBC also allows for screening for Iron-deficiency Anemia. This study aims to determine the prevalence of a low Mean Cell Volume (MCV) in children having a CBC performed during a PED visit and whether physicians acted upon the abnormal value.


METHODS
We present a retrospective cohort study. We reviewed the PED charts of all children 6-36 months of age who had a CBC performed during a 4-month period and the red blood cell mean cell volume was low. Our main outcome variable was whether or not the possible iron deficiency was addressed through documentation of either iron therapy or further investigation.


RESULTS
938 children had a CBC performed during the two periods. Of these, 78 (8%) had an abnormal MCV or Hemoglobin with no previously identified explanation. Physicians documented either treatment or follow-up investigations in 27 cases (35%, 95% CI: 24-46%). Factors associated with the physician documenting either treatment or investigation plan were the following: hemoglobin level (OR 12.6; 95%CI: 4.0, 39) and age < or = 18 months (OR 4.2; 95%CI: 1.4, 13).


CONCLUSIONS
Children who have had a CBC in the PED can be screened for iron deficiency at no additional cost. Physicians may be under-utilizing this information.
Pusic
Martin V
MV
Dept of Pediatrics, University of B.C., Vancouver, BC, Canada. mpusic@cw.bc.ca
Dawyduk
Brenda J
BJ
Mitchell
David
D
D018798:Anemia, Iron-Deficiency / Q000175:diagnosis*; D001772:Blood Cell Count; D002170:Canada; D002675:Child, Preschool; D015331:Cohort Studies; D004909:Erythrocyte Indices; D006454:Hemoglobins / Q000032:analysis*; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008403:Mass Screening; D010372:Pediatrics / Q000193:education; D012189:Retrospective Studies; D013192:Staff Development
D006454:Hemoglobins