Unraveling of Multifactorial Etiology and Risk Factors of Severe Anemia HB ≤ 6 g/dL

Easha-Tur- Razia; Sara Arshad Khan; Abdul Khalid Awan

doi:10.70749/ijbr.v2i02.157

Authors

Easha-Tur-Razia Department of Medicine, Abbas Institute of Medical Sciences, Muzaffarabad, AJK, Pakistan.
Sara Arshad Khan Department of Medicine, Abbas Institute of Medical Sciences, Muzaffarabad, AJK, Pakistan.
Abdul Khalid Awan Department of Medicine, Abbas Institute of Medical Sciences, Muzaffarabad, AJK, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v2i02.157

Keywords:

Anemia, Hemoglobin, Iron Deficiency, Vitamin B12

Abstract

Background: Anemia is an alarming worldwide health condition affecting individuals from modernized and countries that underdeveloped, with significant implications for human health and socio-economic development.

Aims: This research aimed to find the primary risk factors linked with severe anemia (HB ≤ 6 g/dL) and assess the relative contribution of different factors, including nutritional status, chronic diseases, infections, and genetic factors.

Methodology: A cross-sectional study investigated the fundamental causes and risk factors of disease anemia (HB≤ 6 g/dL). The following study was conducted at the Abbas Institute of Medical Sciences, Muzaffarabad AJK Pakistan. The data was collected through a nonprobability purposive sampling technique. Multivariate analysis was applied using logistic regression to identify specific risk factors for severe anemia.

Results: The mean age of the patients was 34.2 years (SD 10.8), with 60% from low socioeconomic status. The mean iron level was 30.4 (SD 12.5) and the mean vitamin B12 level was 190.3 pg/mL (SD 2.3). 46.7% had a history of chronic diseases, with 20.0% having type 2 diabetes and 13.3% having renal diseases. 26.7% were suffering from infections. Chronic disease history significantly increases the risk (OR 2.50, p=0.004).

Conclusion: The study population had low hemoglobin and iron levels, with a high proportion of patients having chronic diseases. Severe anemia was significantly associated with low iron levels and Vitamin B12 deficiency, chronic diseases, and infections, increasing the risk of severe anemia

References

Ioannou P, Papazachariou A, Tsafaridou M, Koutroubakis IE, Kofteridis DP. Etiology of Anemia and Risk Factors of Mortality among Hospitalized Patients: A Real-Life Retrospective Study in a Tertiary Center in Greece. Hematol Rep. 2023;15(2):347–57.

Krishnapillai A, Omar MA, Ariaratnam S, Awaluddin S, Sooryanarayana R, Kiau HB, et al. The Prevalence of Anemia and Its Associated Factors among Older Persons: Findings from the National Health and Morbidity Survey (NHMS) 2015. Int J Environ Res Public Health [Internet]. 2022 May 1 [cited 2024 Aug 15];19(9). Available from: https://pubmed.ncbi.nlm.nih.gov/35564378/

J Brian Lanier 1, James J Park 2 RCC 3. Am Fam Physician. 2018 [cited 2024 Aug 15]. Anemia in Older Adults | AAFP. Available from: https://www.aafp.org/pubs/afp/issues/2018/1001/p437.html

Allen LH. Biological mechanisms that might underlie iron’s effects on fetal growth and preterm birth. J Nutr [Internet]. 2001 [cited 2024 Aug 16];131(2S-2). Available from: https://pubmed.ncbi.nlm.nih.gov/11160591/

Chung SS, Yeh CH, Feng SJ, Lai CS, Yang JJ, Chen CC, et al. Demographic and Health Survey ethiopia. Proceedings of the International Symposium on the Physical and Failure Analysis of Integrated Circuits, IPFA. 2016. 279–282 p.

Johnson LE. Iron Deficiency - Disorders of Nutrition - MSD Manual Consumer Version [Internet]. 2023 [cited 2024 Aug 16]. Available from: https://www.msdmanuals.com/home/disorders-of-nutrition/minerals/iron-deficiency

Girelli D, Marchi G, Camaschella C. Anemia in the Elderly. HemaSphere [Internet]. 2018 Jun 1 [cited 2024 Aug 15];2(3). Available from: https://pubmed.ncbi.nlm.nih.gov/31723768/

Low Haemoglobin Can Lead To Death: Here’s What You Need To Know [Internet]. 2023 [cited 2024 Aug 15]. Available from: https://healthmatch.io/anemia/how-low-can-hemoglobin-go-before-death#the-lowdown

Bonde AN, Blanche P, Staerk L, Gerds TA, Gundlund A, Gislason G, et al. Oral anticoagulation among atrial fibrillation patients with anaemia: an observational cohort study. Eur Heart J [Internet]. 2019 Dec 7 [cited 2024 Aug 15];40(46):3782–90. Available from: https://pubmed.ncbi.nlm.nih.gov/30932145/

Goodnough LT, Schrier SL. Evaluation and management of anemia in the elderly. Am J Hematol. 2014;89(1):88–96.

Nambiema A, Robert A, Yaya I. Prevalence and risk factors of anemia in children aged from 6 to. BMC Public Health. 2019;19(1):1–9.

Getaneh Z, Enawgaw B, Engidaye G, Seyoum M, Berhane M, Abebe Z, et al. Prevalence of anemia and associated factors among school children in Gondar town public primary schools, northwest Ethiopia: A school-based cross-sectional study. PLoS One. 2017;12(12):1–13.

Blum LV, Zierentz P, Hof L, Kloka JA, Messroghli L, Zacharowski K, et al. The impact of intravenous iron supplementation in elderly patients undergoing major surgery. BMC Geriatr [Internet]. 2022;22(1):1–12. Available from: https://doi.org/10.1186/s12877-022-02983-y

Beutler E, Waalen J. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood [Internet]. 2006 Mar 1 [cited 2024 Aug 16];107(5):1747–50. Available from: https://pubmed.ncbi.nlm.nih.gov/16189263/

Garn SM, Ryan AS, Abraham S, Owen G. Suggested sex and age appropriate values for “low” and “deficient” hemoglobin levels. Am J Clin Nutr. 1981 Sep 1;34(9):1648–51.

Beutler E, West C. Hematologic differences between African-Americans and whites: the roles of iron deficiency and alpha-thalassemia on hemoglobin levels and mean corpuscular volume. Blood [Internet]. 2005 Jul 15 [cited 2024 Aug 16];106(2):740–5. Available from: https://pubmed.ncbi.nlm.nih.gov/15790781/

Almoznino-Sarafian D, Shteinshnaider M, Tzur I, Bar-Chaim A, Iskhakov E, Berman S, et al. Anemia in diabetic patients at an internal medicine ward: Clinical correlates and prognostic significance. Eur J Intern Med [Internet]. 2010 Apr 1 [cited 2024 Aug 16];21(2):91–6. Available from: http://www.ejinme.com/article/S0953620509002453/fulltext

Safiri S, Kolahi AA, Noori M, Nejadghaderi SA, Karamzad N, Bragazzi NL, et al. Burden of anemia and its underlying causes in 204 countries and territories, 1990–2019: results from the Global Burden of Disease Study 2019. J Hematol Oncol [Internet]. 2021;14(1):1–16. Available from: https://doi.org/10.1186/s13045-021-01202-2

Melku M, Alene KA, Terefe B, Enawgaw B, Biadgo B, Abebe M, et al. Anemia severity among children aged 6-59 months in Gondar town, Ethiopia: A community-based cross-sectional study. Ital J Pediatr. 2018;44(1):1–12.

Aliyo A, Jibril A. Assessment of anemia and associated risk factors among children under-five years old in 9+the West Guji Zone, southern Ethiopia: Hospital-based cross-sectional study. PLoS One [Internet]. 2022;17(7 July):1–11. Available from: http://dx.doi.org/10.1371/journal.pone.0270853