Prevalence of anemia among elderly patients in an emergency room setting

Purpose: Anemia is highly prevalent in geriatric patients and associated with increased morbidity, functional and cognitive decline. German prevalence data are rare and no treatment guidelines exist for the elderly. Anemia often remains unconsidered in this population. This study evaluates prevalence of anemia among geriatric patients in an emergency room (ER) setting and the performed diagnostic and therapeutic steps. Subjects: Data of 1045 elderly patients > 70 years admitted to the ER at our university hospital between January and August 2010 were retrospectively analyzed (384 female and 474 male in-patients, 92 female and 95 male out-patients). Anemia definition: hemoglobin < 12 g/dL (female) and < 13 g/dL (male). Diagnostic and therapeutic steps, medication and hemoglobin (hb) characteristics at transfer from ER to other departments were evaluated. Results: Among in-patients anemia was found in 54.2%, among out-patients in 36.4% (P < 0.001). Hb was significantly lower in anemic in-patient men (P = 0.007) compared to anemic out-patient men. No such difference was found among women. Anemic patients' age did not influence the hb level. There were department specific differences in hb level as well as diagnostics and therapy of anemia. Only 12% of all evaluable anemic in-patients received a non-drug anemia treatment, mostly consisting of transfusions. Discussion/Conclusion: More than 50% of all elderly patients suffered from anemia; less than one fifth received either anti-anemic medication or non-drug treatment; insufficiency of medical care in this study group can be assumed; close intersdisciplinary cooperation with geriatrician in ER is necessary with development of diagnostic and therapeutic guidelines for anemic elderly. (C) 2013 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.