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老年住院患者贫血:患病率及临床影响

Anemia in elderly hospitalized patients: prevalence and clinical impact.

作者信息

Migone De Amicis Margherita, Poggiali Erika, Motta Irene, Minonzio Francesca, Fabio Giovanna, Hu Cinzia, Cappellini Maria Domenica

机构信息

Department of Internal Medicine, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via F. Sforza 35, 20122, Milan, Italy,

出版信息

Intern Emerg Med. 2015 Aug;10(5):581-6. doi: 10.1007/s11739-015-1197-5. Epub 2015 Jan 30.

Abstract

Anemia is a common finding in elderly individuals. Several studies have shown a strong relationship between anemia, morbidity and mortality, suggesting anemia as a significant independent predictor of adverse outcome in elderly hospitalized patients. The pathophisiology of anemia in the elderly is not yet completely understood. Several mechanisms are involved. We investigated the prevalence of anemia in a cohort of 193 elderly patients admitted to the Internal Medicine Ward of Ca'Granda Policlinico Hospital along 6 months, and its relationship to comorbidities and to the length of hospitalization. Anemia was classified according to the WHO criteria. The majority of patients (48 %) had a mildmoderate, normocytic anemia; severe anemia was found in 8 out of 92 anemic patients. In a subgroup of patients erythropoietin was tested and resulted statistically higher if compared to non-anemic controls (p = 0.003). Considering the most common cause of anemia, nutritional deficiency, chronic renal disease and anemia of chronic disease were found respectively in 36, 15 and 25 % of cases. Unexplained anemia was diagnosed in 24 % of patients, according to the literature. Anemia was independently associated with increased length of hospital stay. Our study confirmed a high prevalence of anemia in elderly patients, and its association with a higher number of comorbidities and a longer stay. A correct clinical approach to anemia in elderly hospitalized patients is essential, considering its negative impact on patients' quality of life, and its social burden in term of healthcare needs and costs.

摘要

贫血在老年人中很常见。多项研究表明贫血与发病率和死亡率之间存在密切关系,提示贫血是老年住院患者不良结局的重要独立预测因素。老年人贫血的病理生理学尚未完全明确,涉及多种机制。我们调查了193名入住卡格兰达综合医院内科病房达6个月的老年患者队列中的贫血患病率,及其与合并症和住院时间的关系。贫血根据世界卫生组织标准进行分类。大多数患者(48%)患有轻度至中度正细胞性贫血;92名贫血患者中有8名患有严重贫血。在一组患者中检测了促红细胞生成素,结果显示与非贫血对照组相比有统计学意义的升高(p = 0.003)。考虑到贫血最常见的原因,营养缺乏、慢性肾病和慢性病性贫血分别在36%、15%和25%的病例中发现。根据文献,24%的患者被诊断为不明原因贫血。贫血与住院时间延长独立相关。我们的研究证实老年患者贫血患病率高,且与更多合并症和更长住院时间相关。考虑到贫血对患者生活质量的负面影响及其在医疗需求和成本方面的社会负担,对老年住院患者贫血采取正确的临床处理方法至关重要。

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