Randi Maria Luigia, Bertozzi Irene, Santarossa Claudia, Cosi Elisabetta, Lucente Fabrizio, Bogoni Giulia, Biagetti Giacomo, Fabris Fabrizio
First Clinical Medicine, Department of Internal Medicine-DIMED, University of Padua, via Giustiniani 2, 35123 Padova, Italy.
J Clin Med. 2020 Mar 30;9(4):950. doi: 10.3390/jcm9040950.
Anemia is extremely common in hospitalized patients who are old and often with multiple diseases. We evaluated 435 consecutive patients admitted in the internal medicine department of a hub hospital and 191 (43.9%) of them were anemic. Demographic, historic and clinical data, laboratory tests, duration of hospitalization, re-admission at 30 days and death were recorded. Patients were stratified by age (<65, 65-80, >80 years), anemia severity, and etiology of anemia. The causes of anemia were: iron deficiency in 28 patients, vitamin B and folic acid deficiencies in 6, chronic inflammatory diseases in 80, chronic kidney disease in 15, and multifactorial in 62. The severity of the clinical picture at admission was significantly worse ( < 0.001), length of hospitalization was longer ( < 0.001) and inversely correlated to the Hb concentration, re-admissions and deaths were more frequent ( 0.017) in anemic compared to non-anemic patients. A specific treatment for anemia was used in 99 patients (36.6%) (transfusions, erythropoietin, iron, vitamin B and/or folic acid). Anemia (and/or its treatment) was red in the discharge letter only 54 patients. Even if anemia is common, in internal medicine departments scarce attention is paid to it, as it is generally considered a "minor" problem, particularly in older patients often affected by multiple pathologies. Our data indicate the need of renewed medical attention to anemia, as it may positively affect the outcome of several concurrent medical conditions and the multidimensional loss of function in older hospitalized patients.
贫血在老年住院患者中极为常见，这些患者往往患有多种疾病。我们评估了一家中心医院内科连续收治的435例患者，其中191例（43.9%）贫血。记录了患者的人口统计学、病史和临床数据、实验室检查结果、住院时间、30天内再次入院情况及死亡情况。患者按年龄（<65岁、65 - 80岁、>80岁）、贫血严重程度和贫血病因进行分层。贫血的病因如下：缺铁性贫血28例，维生素B和叶酸缺乏6例，慢性炎症性疾病80例，慢性肾脏病15例，多因素所致62例。与非贫血患者相比，贫血患者入院时临床表现的严重程度明显更差（<0.001），住院时间更长（<0.001）且与血红蛋白浓度呈负相关，再次入院和死亡更为频繁（0.017）。99例患者（36.6%）接受了贫血的特异性治疗（输血、促红细胞生成素、铁剂、维生素B和/或叶酸）。出院小结中仅54例提到了贫血（和/或其治疗）。即使贫血很常见，但在内科，人们对其关注甚少，因为它通常被视为一个“小”问题，尤其是在常受多种疾病影响的老年患者中。我们的数据表明，需要重新重视贫血问题，因为它可能对多种并发疾病的治疗结果以及老年住院患者多维度的功能丧失产生积极影响。
