Department of Internal Medicine, Hôpitaux Civils de Colmar, Colmar, France.
Eur J Intern Med. 2012 Sep;23(6):524-8. doi: 10.1016/j.ejim.2012.03.013. Epub 2012 Apr 13.
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.
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.
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.
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.
贫血是老年人的一个严重问题，约三分之一的普通人群贫血的原因不明。迄今为止，只有少数研究关注住院患者。
我们前瞻性地纳入了年龄在 65 岁及以上、在内科住院的贫血患者（根据 OMS 标准）。收集了典型的临床数据，并进行了包括铜在内的标准化生物检测。
在 360 例患者中，有 191 例（53%）为贫血患者；然而，由于数据不完整，有 96 例被排除在外。在剩下的 95 例患者中，有 45 例为男性（47.4%），50 例为女性（52.6%）；患者平均年龄为 79.7 岁（66-101 岁）。在 95 例患者中，至少有一个贫血原因被诊断出，有 87 例（91.6%）患者存在贫血，有 44 例（46.3%）患者贫血为多因素所致。贫血的五个最常见原因是炎症（62.1%）、缺铁（30.5%）、叶酸缺乏（21%）、慢性肾衰竭（17.9%）和钴胺素缺乏（11.6%）。只有 27.5%的缺铁性贫血患者存在小细胞性贫血，而只有 7.4%的叶酸和/或钴胺素缺乏患者存在大细胞性贫血。有 8 例患者的贫血原因无法确定。所有患者的铜均正常。
针对老年住院患者的预定义方案能够确定 91.6%的贫血病因；显著的是，贫血常常由多种因素引起（43.5%）。基于平均红细胞体积的诊断方向似乎与平均细胞体积谱不相关。最后，原因不明的贫血很少见，而且在任何情况下都没有记录到铜缺乏。
