McCartney David, Shine Brian, Hay Deborah, Lasserson Daniel S
NIHR In Practice Fellow, Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK.
Consultant in Chemical Pathology, Department of Clinical Biochemistry, Oxford University Hospitals Foundation Trust, Oxford, UK.
BJGP Open. 2017 Oct 4;1(4):bjgpopen17X101157. doi: 10.3399/bjgpopen17X101157. eCollection 2018 Jan.
Anaemia is common in older people and the identification of potentially reversible haematinic deficiencies relies on appropriate investigation, often undertaken in primary care.
To determine the laboratory prevalence of anaemia, the types of anaemia observed, and the biochemical and haematological investigations undertaken to characterise any associated haematinic abnormality in older primary care patients.
DESIGN & SETTING: A retrospective primary care based study of patients aged >65 years undergoing a full blood count in Oxfordshire, UK between 1 January 2012 and 31 December 2013.
Consecutive patients aged >65 years with a full blood count were identified retrospectively from a laboratory database. Patient demographics, number of blood tests and additional laboratory investigations requested were recorded. World Health Organisation (WHO) criteria were used to define anaemia.
In total 151 473 full blood counts from 53 890 participants were included: 29.6% of patients were anaemic. The majority had a normocytic anaemia (82.4%) and 46.0% of participants with anaemia had no additional investigations performed. The mean haemoglobin was lower in the anaemic group that underwent further investigation than those who did not (Hb 10.68 g/dl versus 11.24 g/dl, <0.05): 33.2 % of patients with a microcytic anaemia (mean cell volume <80) did not have any markers of iron status measured.
A large proportion of older adults in primary care with a recent blood test are anaemic, the majority with a normocytic anaemia, with evidence of inadequate investigation. Those with lower haemoglobin are more likely to be further investigated. Further work is needed to understand the approach to anaemia in older adults in primary care.
贫血在老年人中很常见，识别潜在可逆性造血素缺乏依赖于适当的检查，这类检查通常在初级保健中进行。
确定老年初级保健患者中贫血的实验室患病率、观察到的贫血类型，以及为明确任何相关造血素异常而进行的生化和血液学检查。
一项基于回顾性初级保健的研究，研究对象为2012年1月1日至2013年12月31日期间在英国牛津郡进行全血细胞计数的65岁以上患者。
从实验室数据库中回顾性识别连续的65岁以上进行全血细胞计数的患者。记录患者人口统计学信息、血液检查次数及所要求的其他实验室检查。采用世界卫生组织（WHO）标准定义贫血。
共纳入来自53890名参与者的151473次全血细胞计数：29.6%的患者贫血。大多数患者为正细胞性贫血（82.4%），46.0%的贫血参与者未进行其他检查。接受进一步检查的贫血组平均血红蛋白低于未接受进一步检查的组（血红蛋白10.68g/dl对11.24g/dl，P<0.05）：33.2%的小细胞性贫血（平均细胞体积<80）患者未检测任何铁状态指标。
在初级保健中近期进行过血液检查的很大一部分老年人贫血，大多数为正细胞性贫血，且存在检查不足的证据。血红蛋白较低的患者更有可能接受进一步检查
