3 days popular7 days popular1 month popular3 months popular

Thousands of emergency hospitalisations in Scotland due to iron deficiency anaemia might be prevented

Analysis of Scottish hospital records has uncovered over 11,000 potentially preventable, emergency hospital admissions for iron deficiency anaemia (IDA).1

The findings from a report published today, “Iron deficiency anaemia in Scotland: current situation and key recommendations” highlight how IDA is not being efficiently detected and managed in the community. This is despite IDA being identified as a condition where emergency hospital admissions can be prevented through effective management. 2

IDA is a common health concern that is most commonly associated with heavy menstrual cycles in women. 3,4 It also affects 2-5% of adult men and post-menopausal women, with blood loss from the gastrointestinal (GI) tract as the most common cause of IDA in these groups.4 IDA arises when the amount of iron absorbed by the body is less than that being lost, which occurs for three main reasons; blood loss, inflammation and malabsorption.3,5

This means IDA is prevalent in patients with common chronic conditions such as inflammatory bowel disease (IBD), chronic heart failure, chronic obstructive pulmonary disease (COPD), kidney disease and rheumatoid arthritis.3,5-7

When comparing data between Scotland and England, 49.9% of IDA admissions in Scotland were emergencies, compared to England where 19.7% of IDA admissions were emergencies.1,8 This is concerning as emergency admissions are costlier than planned hospital visits.1

The data is released at a time when the Scottish Government is committed to reducing the total time spent in hospital beds and is pushing back a planned increase from 95%-98% in the target for people seen within 4 hours in A&E.9

Commenting on the findings, report author Dr Ian Arnott (Consultant Gastroenterologist at the Western General Hospital, Edinburgh) said, “It is clear IDA is under treated and under diagnosed. Through my work with the UK IBD audit we found that only 44% of patients received treatment for IDA despite guidelines recommending that all patients should receive iron therapy after diagnosis. We need to work closer with our colleagues in primary care to ensure people are diagnosed and managed appropriately.”

The data were analysed for:

  • IDA admission trends by regional Health Boards
  • patient demographics of those diagnosed with IDA in hospitals

The number and type of IDA admissions varied widely between regional Health Boards:

  • admissions per population varied seven-fold from the lowest to the highest1
  • the proportion of admissions identified as emergency varied five-fold1

The majority of admissions were female (65.1%) and most likely to be patients over 75 years old (43.2%).1 In patients aged 75 and over, IDA related hospital stays are more likely to be emergencies and more likely to require at least one night in hospital.

The report outlines a number of practical steps clinicians, payers and policy makers can make to improve the situation in Scotland. These include, working towards the quality standards recommended by the British Society of Gastroenterology, analysing current IDA treatment pathways, and reviewing the current lack of indicators and targets relating to the quality of care in IDA.4