Abstract

OBJECTIVE

The number of chronic diseases, including anemia, increase with aging. While the incidence of anemia is around 10% in adults at or above 65 years of age, it increases to 20-25% in subjects at or above 85 years of age and to almost 40-50% among inpatients. There is scarce evidence in our county describing the incidence of anemia in geriatric patients. This study aims to evaluate anemia in geriatric inpatient settings.

METHODS

A retrospective review was completed to identify inpatients at or above 65 years of age who had treatment at a general internal medicine and geriatric inpatient department from 01.01.2011 to 30.06.2013. Demographic data, chronic diseases, medications used, hospitalization period and underlying cause are recorded. Patients are divided into three groups, including young old, old-old and the oldest. Anemia is defined as hemoglobin (Hb) values below 13 g/dL for male subjects and below 12 g/dL for female subjects,. The lower limit of normal (LLN) is 200 pmol/L for Vitamin B12 and 4 nmol/L for folic acid. Baseline laboratory values are evaluated. Chronic disease anemia is defined as serum ferritin level > 100 µg/L and transferrin saturation >20%, while anemia secondary to chronic renal failure is defined as glomerular filtration rate (GFR) < 30 ml/min. Iron deficiency anemia is characterized as serum ferritin level < 45 µg/L and transferrin saturation <20 percent. Hematology pathology is diagnosed in the light of peripheral smear and bone marrow biopsy.

RESULTS

The mean age of 148 patients enrolled in the study is 78, 75 ± 7.46 years. Of all patients, 31.7% were young old, 42.8% old-old. Female elderly account for 50.6 percent. Mean hospitalization period is 15 ± 14.8 days. Of all patients, 76.3% are anemic.. This study demonstrated that underlying causes of anemia are Anemia of chronic inflammation (ACI) by 53.9% hematological malignancies by 15% and iron deficiency anemia by 13.2 % in decreasing order.

CONCLUSION

The incidence of anemia is remarkably high, 76.3%, in a geriatric population treated in aninpatient setting. The most common underlying cause of anemia is identified as ACI.