Zilinski Janek, Zillmann Robert, Becker Ingrid, Benzing Thomas, Schulz Ralf-Joachim, Roehrig Gabriele
Geriatrics Department, University Hospital Cologne, Cologne, Germany.
Ann Hematol. 2014 Oct;93(10):1645-54. doi: 10.1007/s00277-014-2110-4. Epub 2014 May 29.
The purpose of this cross-sectional prospective study was to determine the prevalence of anemia among elderly hospitalized patients in Germany and to investigate its association with multidimensional loss of function (MLF). One hundred participants aged 70 years or older from two distinct wards (50 each from an emergency department and a medical ward, respectively) underwent a comprehensive geriatric assessment (CGA) consisting of the following six tools: Barthel Index, mini-mental state examination, clock-drawing test, timed up and go test, Esslinger transfer scale, and Daniels test. MLF as an aggregated outcome was diagnosed when three or more tests of the CGA showed an abnormal result. Anemia was defined according to WHO criteria as a hemoglobin (Hb) concentration of <13 g/dL for men and <12 g/dL for women. The prevalence of anemia was 60 %. Overall, 61 % of patients presented with three or more abnormal results in the six tests of the CGA and, thus, with MLF. Using logistic regression, we found a significant association of both anemia and low Hb concentrations with abnormal outcomes in five tests of the CGA and, therefore, with domain-specific deficits like mobility limitations, impaired cognition, and dysphagia. Furthermore, being anemic increased the odds of featuring MLF more than fourfold. This significant relationship persisted after adjustment for various major comorbidities. Both anemia and geriatric conditions are common in the hospitalized elderly. Given the association of anemia with MLF, Hb level might serve as a useful geriatric screening marker to identify frail older people at risk for adverse outcomes.
这项横断面前瞻性研究的目的是确定德国老年住院患者贫血的患病率,并调查其与多维功能丧失(MLF)的关联。来自两个不同病房的100名70岁及以上的参与者(分别来自急诊科和内科病房各50名)接受了全面的老年医学评估(CGA),该评估由以下六种工具组成:巴氏指数、简易精神状态检查、画钟试验、定时起立行走试验、埃斯林格转移量表和丹尼尔斯试验。当CGA的三项或更多测试结果异常时,将MLF诊断为综合结果。根据世界卫生组织的标准,贫血定义为男性血红蛋白(Hb)浓度<13 g/dL,女性<12 g/dL。贫血的患病率为60%。总体而言,61%的患者在CGA的六项测试中有三项或更多异常结果,因此患有MLF。使用逻辑回归分析,我们发现贫血和低Hb浓度与CGA五项测试中的异常结果均存在显著关联,因此与特定领域的缺陷如行动受限、认知障碍和吞咽困难有关。此外,贫血使出现MLF的几率增加了四倍多。在对各种主要合并症进行调整后,这种显著关系仍然存在。贫血和老年疾病在住院老年人中都很常见。鉴于贫血与MLF之间的关联,Hb水平可能作为一种有用的老年筛查标志物,以识别有不良结局风险的体弱老年人。