[Incidence and predictive factors of iron deficiency anemia after acute non-variceal upper gastrointestinal bleeding without portal hypertension].
BACKGROUND
There are few studies on iron deficiency anemia (IDA) after non-variceal acute upper gastrointestinal bleeding (UGIB) in patients without portal hypertension.


OBJECTIVE
To define the incidence of IDA after UGIB, to characterize the predictive factors for IDA and to design algorithms that could help physicians identify those patients who could benefit from iron therapy.


METHODS
We registered 391 patients with UGIB between April 2007 and May 2009. Patients with portal hypertension and those with clinical or/and biological conditions that could affect the ferrokinetic pattern were excluded. Blood analyses were performed, including ferric parameters upon admission, on the 5th day, and on the 30th day after the hemorrhage episode. We used a multiple logistic regression model and a classification and regression tree model.


RESULTS
A total of 124 patients were included, of which 76 (61.3%) developed IDA 30 days after UGIB. The predictive variables were age >75 years (P=.037; OR 3.9; 95% CI: 1.3-11.6), initial urea level >80mg/dL (P=.027; OR 2.9; 95% CI: 1.1-7.6), initial ferritin level ≤65ng/dL (P=.002; OR 7.6; 95% CI: 2.9-18.5), initial hemoglobin level ≤100g/L (P=.003; OR 3.2; 95% CI: 1.3-8.0), hemoglobin level on the 5th day ≤100g/L (P<.001; OR 14.9; 95% CI: 3.6-61.1) and the value of the transferrin saturation index on the 5th day <10% (p<0.001; OR 7.2; 95% CI: 2.6-20.3).


CONCLUSIONS
Most patients with UGIB developed IDA 30 days after the episode. Identification of the predictive factors for IDA may help to establish guidelines for the administration of iron therapy.
Servicio de Aparato Digestivo, Hospital Universitari Arnau de Vilanova, Lérida, España; Institut de Recerca Biomèdica de Lleida, Lérida, España. Electronic address: mplanella.lleida.ics@gencat.cat.
Montserrat
M
Planella de Rubinat
Institut de Recerca Biomèdica de Lleida, Lérida, España; Servicio de Laboratorio Clínico, Hospital Universitari Arnau de Vilanova, Lérida, España.
Montserrat
M
Teixidó Amorós
Servicio de Aparato Digestivo, Hospital Universitari Arnau de Vilanova, Lérida, España; Institut de Recerca Biomèdica de Lleida, Lérida, España.
Raquel
R
Ballester Clau
Institut de Recerca Biomèdica de Lleida, Lérida, España; Universitat de Lleida, Lérida, España.
Javier
J
Trujillano Cabello
Institut de Recerca Biomèdica de Lleida, Lérida, España; Servicio de Laboratorio Clínico, Hospital Universitari Arnau de Vilanova, Lérida, España.
Mercedes
M
Ibarz Escuer
Servicio de Aparato Digestivo, Hospital Universitari Arnau de Vilanova, Lérida, España; Institut de Recerca Biomèdica de Lleida, Lérida, España; Universitat de Lleida, Lérida, España.
Josep Maria
JM
Reñé Espinet
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology / Q000209:etiology*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects; D003663:Decision Trees; D018450:Disease Progression; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000150:complications*; D005260:Female; D005293:Ferritins / Q000097:blood; D006471:Gastrointestinal Hemorrhage / Q000150:complications*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010438:Peptic Ulcer Hemorrhage / Q000150:complications; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D014168:Transferrin / Q000032:analysis; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D006454:Hemoglobins; D014168:Transferrin; D005293:Ferritins
Acute non-variceal upper gastrointestinal bleeding; Anemia ferropénica; Hemorragia digestiva; Iron deficiency anemia; Logistic models; Modelos logísticos