Anaemia in hospitalised geriatric patients: an underestimated problem

Abstract

Aims: To determine the prevalence, severity, types and determinants of anaemia in hospitalised geriatric patients, and its impact on outcomes.

Methods: Clinical and laboratory data on 587 consecutive patients admitted to our hospital under geriatric medicine in 2014 have been analysed. WHO criteria of anaemia were used: haemoglobin (Hb) < 120 g/L for women, Hb < 130 g/L for men.

Results: The prevalence of anaemia was 49.1% and severe (Hb < 100 g/L) in 12.3%. Iron (transferrin saturation <18%), vitamin B12 (<140 pmol/L) or folate (<9.2 nmol/L) deficiency was found in 67.6%, 3.6% and 2.8% patients, respectively. Iron deficiency was identified in 75.4% of the anaemic patients and in 58.3% among non‐anaemic subjects. On multivariate logistic regression analyses, cardiac failure (OR 2.2, p = 0.020), hypoalbuminaemia (<33 g/L; OR 3.8, p < 0.001), history of fracture (OR 2.5, p = 0.007), iron deficiency (OR 2.1, p = 0.004), serum ferritin <100 μg/L (OR 3.0, p = 0.000), chronic kidney disease (GFR < 60 mL/min/1.73 m2; OR 1.8, p = 0.019), history of cancer (OR 1.2, p = 0.022), gastrointestinal bleeding on admission (OR 6.6, p = 0.015), male gender (OR 1.6, p < 0.007) and age (OR 1.03, p = 0.034) were the main independent associates with anaemia. Anaemia predicted mortality within 3 months (OR 1.6, p = 0.052), while prolonged (>10 days) hospital stay was predicted by iron deficiency (OR 2.6, p = 0.018) and severe anaemia (OR 2.2, p = 0.013).

Conclusions: In hospitalised geriatric patients anaemia is very common, frequently iron deficient in origin, associated with chronic heart and/or renal failure, malnutrition, history of fracture, cancer, male gender and age, and predicts poorer outcomes. More than a half of non‐anaemic patients are iron deficient.