{
  "abstract": "Introduction Anaemia is highly prevalent following upper gastrointestinal bleeding (UGIB), with >90% of patients anaemic at discharge and up to half remaining iron deficient at follow-up. Despite BSG 2021 guidelines recommending iron replacement for all adults with iron deficiency anaemia (IDA) secondary to gastrointestinal blood loss, real-world practice remains variable and UK data are limited. This multicentre study evaluates management of IDA following UGIB.Methods A multicentre prospective observational study, coordinated by a trainee collaborative, was conducted across 6 acute NHS hospitals in the East Midlands. Adults admitted with suspected or confirmed UGIB and Glasgow-Blatchford score >6 were enrolled. Prospectively collected data included demographics, endoscopic findings and interventions, blood transfusion (BT) exposure, inpatient intravenous (IV) iron use, and haemoglobin (Hb) at admission, discharge and 30d.Results Between October and December 2025,133 patients (42 female) were included; median age was 73.5 years (IQR 59.0–81.25). Non-variceal bleeding was identified in 85 patients, portal hypertension-related lesions in 25, and normal examination in 23; 45/133 required endoscopic haemostatic therapy. Median length of hospital stay was 7 days (IQR 4–12). Patients were categorised into 4 treatment groups: BT alone (Group A, n=56), combined BT and IV iron (Group B, n=26), IV iron alone (Group C, n=7), and neither therapy (Group D, n=44). Median admission Hb differed substantially between groups, measuring 68 g/L (IQR 62.8–79.0) in Group A, 56.0 g/L (IQR 51.2–64.8) in Group B, 88 g/L (IQR 78.5–91.0) in Group C, and 96.5 g/L (IQR 87.8–111.0) in Group D. At discharge, median Hb values were comparable between Groups A and B at 88 g/L (IQR 82.0–95.5 and 78.2–95.2, respectively), while higher levels were observed in Group C at 92 g/L (IQR 89.8–92.0) and Group D at 98.5 g/L (IQR 90.0–111.2). Hb follow-up at 30 days was available for 65 patients. Group A (28/65) achieved a median Hb of 95 g/L(IQR 83.8–108.2; +39.7%), Group B (15/65) 107 g/L (IQR 98.0–118.0; +91.1%), Group C (2/65) 126.5 g/L(IQR 116.8–136.2; +43.8%), and Group D (20/65) 108.0 g/L (IQR 104.0–125.0; +11.9%)( figure 1). Overall,6 patients died and one patient was readmitted with recurrent anaemia within 30d of index presentation.Conclusions Post UGIB anaemia and IDA remain undertreated despite national guidance. Combined BT and IV iron was associated with substantially greater haemoglobin recovery at 30d compared with BT alone, while patients receiving no therapy showed minimal improvement. These findings highlight marked variation in practice and support routine integration of IV iron into post-UGIB care pathways, while underscoring the need for a pragmatic RCT with intention-to-treat analysis to define optimal management.Abstract FP1 Figure 1Median Hb changes at 30d",
  "authors": [
    {
      "affiliations": [
        "Nottingham University Hospitals, Nottingham, United Kingdom"
      ],
      "name": "Mohamed Elnagar"
    },
    {
      "affiliations": [
        "Nottingham University Hospitals, Nottingham, United Kingdom"
      ],
      "name": "Sophie Regan"
    },
    {
      "affiliations": [
        "Royal Derby Hospital, Derby, United Kingdom"
      ],
      "name": "Saad Butt"
    },
    {
      "affiliations": [
        "Royal Derby Hospital, Derby, United Kingdom"
      ],
      "name": "Lucy Bennett"
    },
    {
      "affiliations": [
        "Queen’s Hospital, Burton, United Kingdom"
      ],
      "name": "Mohammed Alshawwaf"
    },
    {
      "affiliations": [
        "Pilgrim Hospital, Boston, United Kingdom"
      ],
      "name": "Alaa Gubartalla"
    },
    {
      "affiliations": [
        "Sherwood Forest Hospital, Mansfield, United Kingdom"
      ],
      "name": "Rahman Hameed Mohammed Abdul"
    },
    {
      "affiliations": [
        "Sherwood Forest Hospital, Mansfield, United Kingdom"
      ],
      "name": "Muhammad Naqib Ullah"
    },
    {
      "affiliations": [
        "Chesterfield Royal Hospital, Chesterfield, United Kingdom"
      ],
      "name": "Deekshitha Reddy"
    },
    {
      "affiliations": [
        "Chesterfield Royal Hospital, Chesterfield, United Kingdom"
      ],
      "name": "Bethany Brailsford"
    },
    {
      "affiliations": [
        "Nottingham University Hospitals, Nottingham, United Kingdom"
      ],
      "name": "Aida Jawhari"
    },
    {
      "affiliations": [
        "County Durham and Darlington NHS Foundation Trust, Darlington, United Kingdom"
      ],
      "name": "Anjan Dhar"
    }
  ],
  "title": "FP1 Management of iron deficiency anaemia following upper gastrointestinal bleeding: a prospective multicentre observational study",
  "uid": "424a6700-e8df-50e1-907f-a6a222e8c046"
}