AMBULATORY MANAGEMENT OF ANEMIA: A RETROSPECTIVE VIEW FROM AN ITALIAN MULTIDISCIPLINARY TEAM
(Abstract release date: 05/19/16)
EHA Library. Arboscello E. 06/09/16; 135011; PB2111
Dr. Eleonora Arboscello
Contributions
Contributions
Abstract
Abstract: PB2111
Type: Publication Only
Background
Anemia is one of the most prevalent clinic condition leading to a specialist medical consult. In 2014 our Internal Medicine unit started a Multidisciplinary Anemia Ambulatory (Internist, Immune-Hematologist, Hematologist) with the purpose to rapidly manage, diagnosis and treatment of anemic pts, giving a direct connection between general practitioners and hospital services.
Aims
Evaluate if Multidisciplinary Anemia Ambulatory and its diagnostic-therapeutic path, with the involvement of different Specialists, resulte in an improvement of the coordination and continuity of care, reducing sanitary cost in terms of hospitalization, drugs rationalization and quality of life for patients.
Methods
Retrospective analysis of 212 patients came to our attention for internist consult due to anemia from January 1st 2014 to January 2015.
Results
A total of 212 patients came to our attention for internist consult due to anemia: 165 female and 47 male, medium age 63,23 years (range 19-100). A precise classification of anemia was determined for 187 pts: 130 had iron deficiency anemia (IDA, 61,32%), 17 multifactorial anemia (inflammatory disorders, chronic kidney disease and combined deficiency, 8,02%), 16 combined deficiency anemia (iron and vitamins, 7,55%), 9 chronic kidney disease related anemia (4,25%), 7 anemia secondary to inflammatory chronic disorder (3,30%), 5 B12 deficiency (2,36%), 2 both folate and B12 deficiency (0,94%), 1 folate deficiency (0,47%). Twenty-five pts were not classified due to lack of data. Severity of anemia was defined according to WHO criteria: 53 pts (25%) presented mild anemia, 123 (58%) moderate anemia, 33 (15,6%) severe anemia.We considered comorbidities of internistic relevance, which could be worsened by anemia: cardiovascular (coronary heart disease, arrhythmias, heart failure), 30 pts; neurologic (ischemic and degenerative diseases), 19 pts; respiratory disease (COPD and asthma), 11 pts.Pts were treated according to clinical practice in relation to type, severity and clinical manifestation of anemia.130 pts needed more than one access to ambulatory to correct anemia; data from the second access were: pt responders (normalization of Hb levels or improvement of at least 20 g/L): 78 pts; partial responders (improvement of Hb levels from 5 to 20 g/L): 34 pts; non responders: 18 pts. Fourteen pts needed at least 1 blood red cells transfusion, 12 with severe anemia and 2 with moderate anemia. A total of 93 pts needed deep diagnostic insight through specialist pathways, such as hematologic (4 pts), gastroenterologic (39 pts), gynecologic (37 pts), both gastroenterologic and gynecologic (13 pts). All pts were managed as outpatients, except for 8 pts which required hospitalization due to severity of clinical findings: 4 pts were hospitalized.Among IDA pts, 92 were treated with intravenous iron supplement: 32 with sodium ferric gluconate (SFG) (medium 16,68 vials, range 8-43) and 50 with ferric carboxymaltose (FC) (medium 1,04 vials).FC patients fully responded in 76% and 22% were partial responders.
Conclusion
These preliminary data shows that Multidisciplinary Anemia Ambulatory and its diagnostic-therapeutic path, with the involvement of different Specialists and Operative Unit, resulted in an improvement of the coordination and continuity of care, reducing sanitary cost in terms of hospitalization, drugs rationalization and quality of life for patients. More data will derive from the newborn Anemia Regional Register, which will lead to a better comprehension of the real size of anemia in our local epidemiology
Session topic: E-poster
Keyword(s): Anemia
Type: Publication Only
Background
Anemia is one of the most prevalent clinic condition leading to a specialist medical consult. In 2014 our Internal Medicine unit started a Multidisciplinary Anemia Ambulatory (Internist, Immune-Hematologist, Hematologist) with the purpose to rapidly manage, diagnosis and treatment of anemic pts, giving a direct connection between general practitioners and hospital services.
Aims
Evaluate if Multidisciplinary Anemia Ambulatory and its diagnostic-therapeutic path, with the involvement of different Specialists, resulte in an improvement of the coordination and continuity of care, reducing sanitary cost in terms of hospitalization, drugs rationalization and quality of life for patients.
Methods
Retrospective analysis of 212 patients came to our attention for internist consult due to anemia from January 1st 2014 to January 2015.
Results
A total of 212 patients came to our attention for internist consult due to anemia: 165 female and 47 male, medium age 63,23 years (range 19-100). A precise classification of anemia was determined for 187 pts: 130 had iron deficiency anemia (IDA, 61,32%), 17 multifactorial anemia (inflammatory disorders, chronic kidney disease and combined deficiency, 8,02%), 16 combined deficiency anemia (iron and vitamins, 7,55%), 9 chronic kidney disease related anemia (4,25%), 7 anemia secondary to inflammatory chronic disorder (3,30%), 5 B12 deficiency (2,36%), 2 both folate and B12 deficiency (0,94%), 1 folate deficiency (0,47%). Twenty-five pts were not classified due to lack of data. Severity of anemia was defined according to WHO criteria: 53 pts (25%) presented mild anemia, 123 (58%) moderate anemia, 33 (15,6%) severe anemia.We considered comorbidities of internistic relevance, which could be worsened by anemia: cardiovascular (coronary heart disease, arrhythmias, heart failure), 30 pts; neurologic (ischemic and degenerative diseases), 19 pts; respiratory disease (COPD and asthma), 11 pts.Pts were treated according to clinical practice in relation to type, severity and clinical manifestation of anemia.130 pts needed more than one access to ambulatory to correct anemia; data from the second access were: pt responders (normalization of Hb levels or improvement of at least 20 g/L): 78 pts; partial responders (improvement of Hb levels from 5 to 20 g/L): 34 pts; non responders: 18 pts. Fourteen pts needed at least 1 blood red cells transfusion, 12 with severe anemia and 2 with moderate anemia. A total of 93 pts needed deep diagnostic insight through specialist pathways, such as hematologic (4 pts), gastroenterologic (39 pts), gynecologic (37 pts), both gastroenterologic and gynecologic (13 pts). All pts were managed as outpatients, except for 8 pts which required hospitalization due to severity of clinical findings: 4 pts were hospitalized.Among IDA pts, 92 were treated with intravenous iron supplement: 32 with sodium ferric gluconate (SFG) (medium 16,68 vials, range 8-43) and 50 with ferric carboxymaltose (FC) (medium 1,04 vials).FC patients fully responded in 76% and 22% were partial responders.
Conclusion
These preliminary data shows that Multidisciplinary Anemia Ambulatory and its diagnostic-therapeutic path, with the involvement of different Specialists and Operative Unit, resulted in an improvement of the coordination and continuity of care, reducing sanitary cost in terms of hospitalization, drugs rationalization and quality of life for patients. More data will derive from the newborn Anemia Regional Register, which will lead to a better comprehension of the real size of anemia in our local epidemiology
Session topic: E-poster
Keyword(s): Anemia
Abstract: PB2111
Type: Publication Only
Background
Anemia is one of the most prevalent clinic condition leading to a specialist medical consult. In 2014 our Internal Medicine unit started a Multidisciplinary Anemia Ambulatory (Internist, Immune-Hematologist, Hematologist) with the purpose to rapidly manage, diagnosis and treatment of anemic pts, giving a direct connection between general practitioners and hospital services.
Aims
Evaluate if Multidisciplinary Anemia Ambulatory and its diagnostic-therapeutic path, with the involvement of different Specialists, resulte in an improvement of the coordination and continuity of care, reducing sanitary cost in terms of hospitalization, drugs rationalization and quality of life for patients.
Methods
Retrospective analysis of 212 patients came to our attention for internist consult due to anemia from January 1st 2014 to January 2015.
Results
A total of 212 patients came to our attention for internist consult due to anemia: 165 female and 47 male, medium age 63,23 years (range 19-100). A precise classification of anemia was determined for 187 pts: 130 had iron deficiency anemia (IDA, 61,32%), 17 multifactorial anemia (inflammatory disorders, chronic kidney disease and combined deficiency, 8,02%), 16 combined deficiency anemia (iron and vitamins, 7,55%), 9 chronic kidney disease related anemia (4,25%), 7 anemia secondary to inflammatory chronic disorder (3,30%), 5 B12 deficiency (2,36%), 2 both folate and B12 deficiency (0,94%), 1 folate deficiency (0,47%). Twenty-five pts were not classified due to lack of data. Severity of anemia was defined according to WHO criteria: 53 pts (25%) presented mild anemia, 123 (58%) moderate anemia, 33 (15,6%) severe anemia.We considered comorbidities of internistic relevance, which could be worsened by anemia: cardiovascular (coronary heart disease, arrhythmias, heart failure), 30 pts; neurologic (ischemic and degenerative diseases), 19 pts; respiratory disease (COPD and asthma), 11 pts.Pts were treated according to clinical practice in relation to type, severity and clinical manifestation of anemia.130 pts needed more than one access to ambulatory to correct anemia; data from the second access were: pt responders (normalization of Hb levels or improvement of at least 20 g/L): 78 pts; partial responders (improvement of Hb levels from 5 to 20 g/L): 34 pts; non responders: 18 pts. Fourteen pts needed at least 1 blood red cells transfusion, 12 with severe anemia and 2 with moderate anemia. A total of 93 pts needed deep diagnostic insight through specialist pathways, such as hematologic (4 pts), gastroenterologic (39 pts), gynecologic (37 pts), both gastroenterologic and gynecologic (13 pts). All pts were managed as outpatients, except for 8 pts which required hospitalization due to severity of clinical findings: 4 pts were hospitalized.Among IDA pts, 92 were treated with intravenous iron supplement: 32 with sodium ferric gluconate (SFG) (medium 16,68 vials, range 8-43) and 50 with ferric carboxymaltose (FC) (medium 1,04 vials).FC patients fully responded in 76% and 22% were partial responders.
Conclusion
These preliminary data shows that Multidisciplinary Anemia Ambulatory and its diagnostic-therapeutic path, with the involvement of different Specialists and Operative Unit, resulted in an improvement of the coordination and continuity of care, reducing sanitary cost in terms of hospitalization, drugs rationalization and quality of life for patients. More data will derive from the newborn Anemia Regional Register, which will lead to a better comprehension of the real size of anemia in our local epidemiology
Session topic: E-poster
Keyword(s): Anemia
Type: Publication Only
Background
Anemia is one of the most prevalent clinic condition leading to a specialist medical consult. In 2014 our Internal Medicine unit started a Multidisciplinary Anemia Ambulatory (Internist, Immune-Hematologist, Hematologist) with the purpose to rapidly manage, diagnosis and treatment of anemic pts, giving a direct connection between general practitioners and hospital services.
Aims
Evaluate if Multidisciplinary Anemia Ambulatory and its diagnostic-therapeutic path, with the involvement of different Specialists, resulte in an improvement of the coordination and continuity of care, reducing sanitary cost in terms of hospitalization, drugs rationalization and quality of life for patients.
Methods
Retrospective analysis of 212 patients came to our attention for internist consult due to anemia from January 1st 2014 to January 2015.
Results
A total of 212 patients came to our attention for internist consult due to anemia: 165 female and 47 male, medium age 63,23 years (range 19-100). A precise classification of anemia was determined for 187 pts: 130 had iron deficiency anemia (IDA, 61,32%), 17 multifactorial anemia (inflammatory disorders, chronic kidney disease and combined deficiency, 8,02%), 16 combined deficiency anemia (iron and vitamins, 7,55%), 9 chronic kidney disease related anemia (4,25%), 7 anemia secondary to inflammatory chronic disorder (3,30%), 5 B12 deficiency (2,36%), 2 both folate and B12 deficiency (0,94%), 1 folate deficiency (0,47%). Twenty-five pts were not classified due to lack of data. Severity of anemia was defined according to WHO criteria: 53 pts (25%) presented mild anemia, 123 (58%) moderate anemia, 33 (15,6%) severe anemia.We considered comorbidities of internistic relevance, which could be worsened by anemia: cardiovascular (coronary heart disease, arrhythmias, heart failure), 30 pts; neurologic (ischemic and degenerative diseases), 19 pts; respiratory disease (COPD and asthma), 11 pts.Pts were treated according to clinical practice in relation to type, severity and clinical manifestation of anemia.130 pts needed more than one access to ambulatory to correct anemia; data from the second access were: pt responders (normalization of Hb levels or improvement of at least 20 g/L): 78 pts; partial responders (improvement of Hb levels from 5 to 20 g/L): 34 pts; non responders: 18 pts. Fourteen pts needed at least 1 blood red cells transfusion, 12 with severe anemia and 2 with moderate anemia. A total of 93 pts needed deep diagnostic insight through specialist pathways, such as hematologic (4 pts), gastroenterologic (39 pts), gynecologic (37 pts), both gastroenterologic and gynecologic (13 pts). All pts were managed as outpatients, except for 8 pts which required hospitalization due to severity of clinical findings: 4 pts were hospitalized.Among IDA pts, 92 were treated with intravenous iron supplement: 32 with sodium ferric gluconate (SFG) (medium 16,68 vials, range 8-43) and 50 with ferric carboxymaltose (FC) (medium 1,04 vials).FC patients fully responded in 76% and 22% were partial responders.
Conclusion
These preliminary data shows that Multidisciplinary Anemia Ambulatory and its diagnostic-therapeutic path, with the involvement of different Specialists and Operative Unit, resulted in an improvement of the coordination and continuity of care, reducing sanitary cost in terms of hospitalization, drugs rationalization and quality of life for patients. More data will derive from the newborn Anemia Regional Register, which will lead to a better comprehension of the real size of anemia in our local epidemiology
Session topic: E-poster
Keyword(s): Anemia
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