Department of Medicine and Geriatrics, Fung Yiu King Hospital, Hong Kong, China.
Geriatr Gerontol Int. 2013 Jul;13(3):591-6. doi: 10.1111/j.1447-0594.2012.00942.x. Epub 2012 Sep 19.
There is little data regarding the prevalence and associated comorbidities of anemia in Chinese nursing home older adults. The objective of this study was to investigate the prevalence and associated comorbidities of anemia in Chinese nursing home older adults.
We carried out a retrospective cross-sectional study in nine nursing homes in Hong Kong. The hemoglobin (Hb) level, mean corpuscular volume (MCV), serum creatinine and comorbidities data of residents were examined. Older adults were regarded as anemic according to the World Health Organization criteria (Hb <13 g/dL for men and <12 g/dL for women). The glomerular filtration rate (eGFR) was estimated by the Modification of Diet in Renal Disease Study (MDRD [Chinese-adjusted]) equation. Patients with chronic renal impairment were defined as having eGFR <60 mL/min/1.73 m(2) .
A total of 812 residents were included (mean age 86.0 ± 7.6 years). The mean hemoglobin was 12.0 ± 1.8 g/dL in men and 11.4 ± 1.6g/dL in women. The mean eGFR was 75.1 ± 31.7 mL/min/1.73 m(2) . A total of 67.0% of residents had anemia (70.5% in men and 65.2% in women). Anemic older adults were older and had a higher prevalence of renal impairment than non-anemic older adults (P<0.001). There was no significant difference between the two groups regarding the prevalence of other comorbidities. When stratified into different age groups, there were significant correlations between anemia and renal impairment in all subgroups (age ≤ 80 years, P<0.05; age 81-90 years, P<0.01; age >90 years, P<0.05). The same correlation was found between normocytic anemia and renal impairment. Conversely, when stratified according to eGFR (≥ 60 mL/min/1.73 m(2) vs <60 mL/min/1.73 m(2) ), we did not observe a significant correlation between anemia and age group.
In conclusion, anemia is prevalent in Chinese nursing home residents and is strongly associated with renal impairment. Further studies of early identification and management of anemia with renal impairment are recommended in this population.
有关中国养老院老年人贫血的患病率和相关合并症的数据很少。本研究的目的是调查中国养老院老年人贫血的患病率和相关合并症。
我们在香港的 9 家养老院进行了回顾性横断面研究。检查了居民的血红蛋白（Hb）水平、平均红细胞体积（MCV）、血清肌酐和合并症数据。根据世界卫生组织标准（男性 Hb<13g/dL，女性 Hb<12g/dL），老年人被视为贫血。肾小球滤过率（eGFR）用肾脏病饮食改良试验（MDRD [中国调整]）方程估算。慢性肾功能不全患者定义为 eGFR<60mL/min/1.73m2。
共纳入 812 名居民（平均年龄 86.0±7.6 岁）。男性平均血红蛋白为 12.0±1.8g/dL，女性为 11.4±1.6g/dL。平均 eGFR 为 75.1±31.7mL/min/1.73m2。共有 67.0%的居民贫血（男性为 70.5%，女性为 65.2%）。贫血老年人比非贫血老年人年龄更大，且肾功能不全的患病率更高（P<0.001）。两组间其他合并症的患病率无显著差异。按不同年龄组分层后，所有亚组均存在贫血与肾功能不全之间的显著相关性（年龄≤80 岁，P<0.05；年龄 81-90 岁，P<0.01；年龄>90 岁，P<0.05）。正细胞性贫血与肾功能不全之间也存在同样的相关性。相反，按 eGFR（≥60mL/min/1.73m2 与<60mL/min/1.73m2）分层时，我们未观察到贫血与年龄组之间存在显著相关性。
总之，贫血在中国养老院居民中很常见，与肾功能不全密切相关。建议在该人群中进一步研究早期识别和管理贫血伴肾功能不全。
