Study of anemia in geriatric patients attending a tertiary care hospital in Unnao district

Abstract

Background: Geriatric anemia is a worldwide health issue in view of its high prevalence and related critical morbidity and mortality. It is a typical issue in both elderly men and women of age greater than 65 years, and in men, the haemoglobin concentration below 13gm/dl and in women below 12 gm/dl respectively. Anaemia is often overlooked in elderly patients, despite being evident that physical and physiological decline is associated with low haemoglobin levels. Elderly patients with anemia are heterogeneous in terms of clinical history, coexisting medical conditions, and concomitant medication use than young adults. Aim: The objectives of this study were to estimate the pattern of anemia in the elderly patients and the underlying etiology of anemia. Materials and Methods: This study was a cross sectional study, conducted in patients aged 60 years and above at Department of Pathology, Saraswati Medical College, Unnao, India. Anemia is defined as hemoglobin level less than 13 g/dl in male and 12 g/dl in females. Total 100 elderly patients were included in the study over a period of one year from January 2018 to December 2018, who fulfilled the inclusion criteria of age more than 60 years with anaemia, as per World health organization (WHO). A detailed history, exhaustive clinical examination and symptom analysis, was done in all the patients. Haematological investigations, including peripheral smear and biochemical investigations were done in all patients. Morphological pattern of anaemia was classified based on red cell indices and peripheral smear. Results: A total of 100 cases of anaemia were studied in elderly patients. Males 69% were dominant in numbers compared to females i.e. 31%. The mean age of elderly patients was found to be 68.5 years, with maximum patients in 60-70 age groups. The age group of patients ranged from 60 to 91 years and above. Distribution based on type of anaemia as per characteristics of peripheral smear, normocytic normochromic 49%, followed by microcytic hypochromic 19%, macrocytic 14%, dimorphic 12% and normocytic hypochromic 6%. Distribution of geriatric patients based on clinical presentation, the most common presentation was generalised weakness which constituted to 36%, followed by breathlessness which constituted to 25%, giddiness which constituted to 12%, abdomen pain which constituted to 9%, loss of weight which constituted to 8%, loss of appetite which constituted to 5%, headache which constituted to 3% and diabetes which constituted to 2%. Conclusion: Hospitalized patients are more prone to severe anaemia than population based studies were mild anaemia is common. The morphological and etiological type of anaemia proportions is identical in both population and hospital-based studies. In elderly patients, anaemia is a common disease. It leads to severe morbidity and mortality, if not investigated properly. Early treatment of anemia in elderly patients can prevent severe morbidity.