Life Expectancy Project, 1439 17th Avenue, San Francisco, CA 94122-3402, USA.
Int J Hematol. 2012 Mar;95(3):248-56. doi: 10.1007/s12185-012-1007-z. Epub 2012 Feb 21.
Anemia is a common condition among community-dwelling older adults. The present study investigates the effect of type of anemia on subsequent mortality. We analyzed data from participants of the Third National Health and Nutrition Survey who were aged ≥50 and had valid hemoglobin levels determined by laboratory measurement. Anemia was defined by World Health Organization criteria. 7,171 subjects met our inclusion criterion. Of those with anemia (n = 862, deaths = 491), 24% had nutritional anemia, 11% had anemia of chronic renal disease, 26% had anemia of chronic inflammation, and 39% had unexplained anemia. We found an overall relative risk (RR) for mortality of 1.8 (p < 0.001) comparing those with anemia to those without, after adjusting for age, sex, and race. After we controlled for a number of chronic medical conditions, the overall RR was 1.6. Compared to persons without anemia, we found the following RRs for the type of anemia: nutritional (2.34, p < 0.0001), chronic renal disease (1.70, p < 0.0001), chronic inflammation (1.48, p < 0.0001), and unexplained (1.26, p < 0.01). Anemia is common although not severe in older non-institutionalized adults. When compared with non-anemic older adults, those with nutritional anemia or anemia due to chronic renal disease have the highest mortality risk.
贫血是社区老年人中常见的一种病症。本研究调查了贫血类型对随后死亡率的影响。我们分析了第三次国家健康和营养调查中年龄≥50 岁且实验室测量血红蛋白值有效的参与者的数据。贫血按照世界卫生组织的标准定义。共有 7171 名符合我们纳入标准的参与者。在患有贫血的人中（n=862，死亡人数=491），24%为营养性贫血，11%为慢性肾病性贫血，26%为慢性炎症性贫血，39%为原因不明性贫血。我们发现，在调整年龄、性别和种族后，与无贫血者相比，贫血者的总死亡率相对风险（RR）为 1.8（p<0.001）。在控制了多种慢性疾病后，总体 RR 为 1.6。与无贫血者相比，我们发现以下类型贫血的 RR：营养性贫血（2.34，p<0.0001）、慢性肾病性贫血（1.70，p<0.0001）、慢性炎症性贫血（1.48，p<0.0001）和原因不明性贫血（1.26，p<0.01）。尽管在非住院的老年成年人中贫血并不严重，但贫血很常见。与非贫血的老年成年人相比，营养性贫血或由慢性肾病引起的贫血患者的死亡率风险最高。
