Boennelykke Astrid, Jensen Henry, Granfeldt Østgård Lene Sofie, Falborg Alina Zalounina, Christensen Kaj Sparle, Hansen Anette Tarp, Emery Jon, Vedsted Peter
Research Unit for General Practice, Aarhus, Denmark.
Department of Public Health, Aarhus University, Aarhus, Denmark.
Scand J Prim Health Care. 2021 Sep;39(3):364-372. doi: 10.1080/02813432.2021.1958499. Epub 2021 Jul 30.
Anaemia can be a pointer of underlying severe disease, including undiagnosed malignancy. Subsequent blood tests are essential to classify the anaemia into subtypes and to facilitate targeted diagnostic investigation to ensure timely diagnosis of underlying disease.
We aimed to describe and classify anaemia based on laboratory tests from patients with new-onset anaemia detected in general practice. An additional aim was to analyse associations between patient characteristics and unclassified anaemia (not classifiable according to an algorithm).
Population-based cross-sectional study.
Danish general practice.
A total of 62,731 patients (age: 40-90 years) with new-onset anaemia were identified in Danish laboratory information systems and nationwide registries, and data were obtained for 2014-2018.
We measured the proportion of patients classified into subtypes of anaemia based on blood tests requested by general practitioners within 31 days of the anaemia index date.
Of the 62,731 patients with new-onset anaemia, we identified unclassified anaemia in 78.9% (95% confidence interval (CI): 77.3-80.5) of men and 65.1% (CI: 63.4-66.9) of women. The likelihood of unclassified anaemia increased with age, increasing comorbidity and decreasing severity of anaemia.
The majority of patients with new-onset anaemia could not be classified through a simple algorithm due to missing blood tests, which highlights a potential missed opportunity for diagnosis. Standardised laboratory testing of patients with anaemia is warranted to ensure adequate follow-up and early detection of underlying severe disease.KEY POINTSAnaemia can be a sign of malignancy, and anaemia classification is an important step in the diagnosis of underlying disorders.The majority of patients with anaemia could not be classified according to a simple algorithm due to missing blood tests.Some patient characteristics were associated with a high risk of unclassified anaemia: high age, high comorbidity, and severe anaemia.Standardised laboratory testing in patients with anaemia is needed to inform targeted diagnostic investigation to ensure timely diagnosis.
贫血可能是潜在严重疾病的一个指标，包括未确诊的恶性肿瘤。后续的血液检查对于将贫血分类为不同亚型以及促进针对性的诊断调查以确保及时诊断潜在疾病至关重要。
我们旨在根据在全科医疗中检测出的新发贫血患者的实验室检查结果来描述和分类贫血。另一个目的是分析患者特征与未分类贫血（无法根据算法分类）之间的关联。
基于人群的横断面研究。
丹麦全科医疗。
在丹麦实验室信息系统和全国登记处中识别出总共62731例新发贫血患者（年龄：40 - 90岁），并获取了2014 - 2018年的数据。
我们测量了在贫血指数日期后31天内根据全科医生要求的血液检查被分类为贫血亚型的患者比例。
在62731例新发贫血患者中，我们发现男性中有78.9%（95%置信区间（CI）：77.3 - 80.5）、女性中有65.1%（CI：63.4 - 66.9）为未分类贫血。未分类贫血的可能性随年龄增长、合并症增加和贫血严重程度降低而增加。
由于缺少血液检查，大多数新发贫血患者无法通过简单算法进行分类，这凸显了一个潜在的诊断错失机会。有必要对贫血患者进行标准化实验室检测，以确保充分的随访并早期发现潜在的严重疾病。要点贫血可能是恶性肿瘤的迹象，贫血分类是诊断潜在疾病的重要步骤。由于缺少血液检查，大多数贫血患者无法根据简单算法进行分类。一些患者特征与未分类贫血的高风险相关：高龄、高合并症和严重贫血。需要对贫血患者进行标准化实验室检测，以指导针对性的诊断调查，确保及时诊断。
