Fougère Bertrand, Puisieux François, Chevalet Pascal, Annweiler Cédric, Michel Emeline, Joly Laure, Blanc Frédéric, Azouzi Abdelghani El, Desré-Follet Valérie, Cacoub Patrice
Division of Geriatric Medicine, Tours University Hospital, Tours, France.
CHRU Tours - Pôle Vieillissement, Hôpital Bretonneau, 2 Boulevard Tonnelé, 37044, Tours Cedex 9, France.
BMC Geriatr. 2024 Jan 30;24(1):112. doi: 10.1186/s12877-024-04719-6.
Iron deficiency (ID) is often associated with other comorbidities in older patients and is a factor of morbimortality. However, the prevalence of ID remains poorly documented in this population.
The CARENFER PA study was a French multicenter cross-sectional study whose objective was to evaluate ID in patients (> 75 years) admitted to a geriatric unit. The primary endpoint was the ID prevalence defined as: serum ferritin < 100 µg/L and/or transferrin saturation coefficient (TSAT) < 20%. The Short Physical Performance Battery (SPPB) test was used to identify older patients at high risk of adverse events (e.g., disability, falls, hospitalization, death).
A total of 888 patients (mean age, 85.2 years; women, 63.5%) from 16 French centers were included from October 2022 to December 2022. The prevalence of ID was 57.6% (95% CI, 54.3-60.9) in the cohort of older patients (62.6% in anemic and 53.3% in non-anemic patients; p = 0.0062). ID prevalence increased significantly with the presence of more than three comorbidities (65.6% vs. 55.9%; p = 0.0274), CRP ≥ 12 mg/L (73.0% vs. 49.3%; p < 0.001) and treatment that may influence ID/anemia (60.5% vs. 49.6%; p = 0.0042). In multivariate analysis, only CRP ≥ 12 mg/L was an independent predictive factor of ID (odds ratio, 2.78; 95% CI, 1.92-4.08; p < 0.001). SPPB scores were low (0-6) in 60.5% of patients with ID versus 48.6% of patients without ID (p = 0.0076).
More than half of older patients had ID, including non-anemic patients. ID was associated with the presence of inflammation and a low SPPB score.
NCT05514951.
缺铁（ID）在老年患者中常与其他合并症相关，是一个影响发病和死亡的因素。然而，该人群中铁缺乏症的患病率仍缺乏充分记录。
CARENFER PA研究是一项法国多中心横断面研究，其目的是评估入住老年病房的患者（>75岁）的缺铁情况。主要终点是缺铁患病率，定义为：血清铁蛋白<100μg/L和/或转铁蛋白饱和度系数（TSAT）<20%。采用简短体能状况量表（SPPB）测试来识别有不良事件（如残疾、跌倒、住院、死亡）高风险的老年患者。
2022年10月至2022年12月，来自法国16个中心的888例患者（平均年龄85.2岁；女性占63.5%）被纳入研究。老年患者队列中铁缺乏症的患病率为57.6%（95%CI，54.3 - 60.9）（贫血患者中为62.6%，非贫血患者中为53.3%；p = 0.0062）。随着合并症超过三种（65.6%对55.9%；p = 0.0274）、CRP≥12mg/L（73.0%对49.3%；p < 0.001）以及可能影响缺铁/贫血的治疗（60.5%对49.6%；p = 0.0042），缺铁患病率显著增加。在多变量分析中，只有CRP≥12mg/L是缺铁的独立预测因素（比值比，2.78；95%CI，1.92 - 4.08；p < 0.001）。60.5%的缺铁患者SPPB评分较低（0 - 6），而无缺铁患者中这一比例为48.6%（p = 0.0076）。
超过一半的老年患者存在缺铁，包括非贫血患者。缺铁与炎症的存在以及较低的SPPB评分相关。
NCT05514951。
