An audit of the iron status of patients at Chris Hani Baragwanath Academic Hospital, in Johannesburg, South Africa.

IF 1 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
African Journal of Laboratory Medicine Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI:10.4102/ajlm.v13i1.2509
Jurette S Grove, Siyabonga Khoza, Dineo V Mabuza, Shaida B Khan
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引用次数: 0

Abstract

Background: Iron deficiency is a common disorder, especially in developing countries. Accurately assessing iron status remains challenging, particularly for patients with chronic diseases such as HIV and chronic kidney disease, prevalent in South Africa.

Objective: This study aimed to determine how ferritin cut-offs affect iron status classification in adult patients treated at a tertiary hospital in South Africa. Additionally, it assessed the frequency of these conditions and the impact of age and gender on iron status.

Methods: This retrospective study analysed iron profiles in adult patients from 01 October 2020 to 31 March 2021. Iron status was categorised into five groups: iron deficiency anaemia (IDA), anaemia of chronic disease, IDA with anaemia of chronic disease, iron deficiency without anaemia, and iron replete based on haemoglobin, transferrin saturation, and ferritin levels. The impact of using two different ferritin cut-off values (15 µg/L and 30 µg/L) was investigated.

Results: The study included 3221 complete iron profiles. There was a predominance of female patients (2.2:1 ratio). Anaemia of chronic disease was the most prevalent iron disorder (39%), regardless of ferritin cut-off. Using a higher ferritin cut-off of 30 µg/L significantly increased the detection rates of both IDA and iron deficiency without anaemia (p < 0.001).

Conclusion: This study suggests that a higher ferritin threshold (30 µg/L) might improve diagnosis of iron disorders in settings with high inflammatory diseases. Further studies are needed to refine thresholds. Local guidelines should be adjusted to consider higher ferritin cut-offs, and longitudinal studies are recommended to evaluate long-term outcomes.

What this study adds: This study confirms the use of higher ferritin cut-offs for enhanced detection of iron deficiency states. The findings also emphasise the ongoing need for establishing simple, standardised, and accurate methods for iron status classification.

对南非约翰内斯堡克里斯-哈尼-巴拉夸那思学术医院(Chris Hani Baragwanath Academic Hospital)患者铁质状况的审计。
背景:缺铁是一种常见疾病,尤其是在发展中国家。准确评估铁的状况仍具有挑战性,尤其是对于患有慢性疾病(如南非流行的艾滋病和慢性肾病)的患者:本研究旨在确定铁蛋白临界值如何影响在南非一家三级医院接受治疗的成年患者的铁状态分类。此外,研究还评估了这些疾病的发病频率以及年龄和性别对铁状况的影响:这项回顾性研究分析了 2020 年 10 月 1 日至 2021 年 3 月 31 日期间成年患者的铁概况。根据血红蛋白、转铁蛋白饱和度和铁蛋白水平,将铁状况分为五类:缺铁性贫血(IDA)、慢性病贫血、IDA伴慢性病贫血、缺铁性贫血(无贫血)和铁充足。研究还探讨了使用两种不同的铁蛋白临界值(15 微克/升和 30 微克/升)的影响:研究包括 3221 份完整的铁概况。女性患者占多数(2.2:1)。慢性病贫血是最常见的铁疾病(39%),与铁蛋白临界值无关。使用 30 µg/L 的较高铁蛋白临界值可显著提高 IDA 和无贫血缺铁症的检出率(p < 0.001):这项研究表明,较高的铁蛋白临界值(30 微克/升)可能会提高炎症性疾病高发地区铁紊乱的诊断率。需要进一步研究来完善阈值。应调整地方指南以考虑更高的铁蛋白临界值,并建议开展纵向研究以评估长期结果:这项研究证实了使用更高的铁蛋白临界值可提高对缺铁状态的检测。研究结果还强调,目前需要建立简单、标准化和准确的铁状态分类方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
African Journal of Laboratory Medicine
African Journal of Laboratory Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
1.70
自引率
9.10%
发文量
53
审稿时长
12 weeks
期刊介绍: The African Journal of Laboratory Medicine, the official journal of ASLM, focuses on the role of the laboratory and its professionals in the clinical and public healthcare sectors,and is specifically based on an African frame of reference. Emphasis is on all aspects that promote and contribute to the laboratory medicine practices of Africa. This includes, amongst others: laboratories, biomedical scientists and clinicians, medical community, public health officials and policy makers, laboratory systems and policies (translation of laboratory knowledge, practices and technologies in clinical care), interfaces of laboratory with medical science, laboratory-based epidemiology, laboratory investigations, evidence-based effectiveness in real world (actual) settings.
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