A Cross Sectional Analysis of Etiology of Anemia Among Elderly Patients

Öz

The aim of this study is to evaluate the etiology and features of anemia in elderly patients from the perspective of hematology and to determine the rate of unexplained anemia. The medical records of elderly patients over the age of 65 who applied to the Hematology Department of Ankara Baskent University Hospital between January 2015 and January 2020 were retrospectively analyzed. According to WHO criteria, the threshold value accepted for anemia was Hb <12 g/dL for women and <13 g/dL for men. The prevalence of anemia was 18% among 3330 elderly patients. The ratio of women to men diagnosed with anemia was 1.5:1, and the mean age was 77.34±8.32. The mean Hb value was 9.79±1.75 g/dl and decreased significantly with advancing age (p<0.001). Polypharmacy was present in 68.3% of the patients. The etiological distribution of anemia was nutritional anemia in 339 (56.5%), hematologic malignancy in 127 (21.1%), anemia of chronic disease in 125 (20.8%), and unexplained anemia in 58 (9.7%) patients. 72% of the patients with indications for bone marrow biopsy had the procedure. Anemia in the elderly is a challenging issue due to comorbidity, polypharmacy, and problems in further examination. Hematological evaluation of anemia in elderly patients will reduce the rate of unexplained anemia. Patient selection for invasive procedures should be based on a risk-benefit ratio in frail elderly patients.

Anahtar Kelimeler

• Unexplained anemia
• elderly
• polypharmacy
• prevalence

Yaşlı Hastalarda Anemi Etiyolojisinin Kesitsel Analizi

Öz

Bu çalışmanın amacı yaşlı hastalarda aneminin etiyolojisini ve özelliklerini hematoloji bakış açısıyla değerlendirmek ve açıklanamayan anemi oranını belirlemektir. Ocak 2015-Ocak 2020 tarihleri arasında Ankara Başkent Üniversitesi Hastanesi Hematoloji Kliniğine başvuran 65 yaş üstü yaşlı hastaların tıbbi kayıtları retrospektif olarak incelendi. WHO kriterlerine göre anemi için kabul edilen eşik değer, kadınlarda Hb <12 g/dL, erkeklerde <13 g/dL idi. 3330 yaşlı hastada anemi prevalansı %18 idi. Kadınların anemi tanısı alan erkeklere oranı 1,5:1, yaş ortalaması 77,34±8,32 idi. Ortalama Hb değeri 9,79±1,75 g/dl idi ve yaş ilerledikçe anlamlı olarak azaldı (p<0,001). Hastaların %68,3’ünde polifarmasi mevcuttu. Aneminin etiyolojik dağılımı; 339 (%56,5) hastada beslenme anemisi, 127 (%21,1) hastada hematolojik malignite, 125 (%20,8) hastada kronik hastalık anemisi ve 58 (%9,7) hastada açıklanamayan anemi idi. Kemik iliği biyopsisi endikasyonu olan hastaların %72'sine prosedür uygulandı. Yaşlılarda anemi komorbidite, polifarmasi ve ileri tetkiklerdeki sorunlar nedeniyle zorlu bir konudur. Yaşlı hastalarda aneminin hematolojik olarak değerlendirilmesi açıklanamayan anemi oranını azaltacaktır. İnvaziv prosedürler için hasta seçimi, kırılgan yaşlı hastalarda bir risk-fayda oranına dayanmalıdır.

Anahtar Kelimeler

• Açıklanamayan anemi
• polifarmasi
• prevalans
• yaşlı

Kaynakça

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