Abstract
Background and objectives
Anaemia is a significant problem in the elderly, and the cause of anaemia in approximately
one third of the general population is unidentified. To date, only a few studies have
focused on hospitalised patients.
Patients and methods
We prospectively included anaemic patients (according to OMS criteria) aged 65 years and older who were hospitalised in the internal medicine department. The typical
clinical data were collected, and a standardised set of biological tests, including
cupraemia was performed.
Results
Of 360 total patients, 191 (53%) patients were anaemic; however, 96 patients were
excluded because their data were incomplete. Of the remaining 95 patients that were
included, 45 were men (47.4%) and 50 were women (52.6%); the mean patient age was
79.7 years (66–101 years). At least one cause of anaemia was diagnosed in 87 of the 95 (91.6%) patients,
and anaemia was multifactorial in 44 of the 95 (46.3%) cases. The five most prominent
causes of anaemia were inflammation (62.1%), iron deficiency (30.5%), folic acid deficiency
(21%), chronic renal failure (17.9%) and cobalamin deficiency (11.6%). Microcytosis
was present in only 27.5% of the patients who had an iron deficiency, and macrocytosis
was present in only 7.4% of the patients who had a folic acid and/or cobalamin deficiency.
The cause of anaemia could not be identified for 8 of the patients. The cupraemia
was normal in all the patients.
Conclusion
A predefined protocol for older hospitalised patients was ability to identify the
aetiology of anaemia in 91.6% of the cases; strikingly, anaemia was frequently caused
by more than one factor (43.5%). Diagnostic orientation based on the mean corpuscular
volume does not appear to correlate with mean cellular volume profile. Finally, anaemia
caused by an unknown aetiology is rare and copper deficiency was not documented in
any case.
Keywords
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Article info
Publication history
Published online: April 16, 2012
Accepted:
March 15,
2012
Received in revised form:
March 9,
2012
Received:
December 30,
2011
Identification
Copyright
© 2012 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.
