A Study of the Etiology, contributory factors and correlation of the clinical and laboratory profiles of anemia in elderly patients presenting at a tertiary hospital in rural South India

Joshila Nandhini, G (2016) A Study of the Etiology, contributory factors and correlation of the clinical and laboratory profiles of anemia in elderly patients presenting at a tertiary hospital in rural South India. Masters thesis, Tirunelveli Medical College, Tirunelveli.


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BACKGROUND: Anemia is defined as a state of decreased oxygen carrying capacity of the blood wherein the hemoglobin is less than 13 g/ml in men and less than12 g/ml in non pregnant women by WHO reference standards. The demographic transition with ageing of population is a global phenomenon and in recent years there has been an increasing international awareness of health issues relating to aging population. The prevalence of anemia among elderly Indians, as reported in Indian cross sectional studies is between 6 and 30 % among men and between 10 and 20 % among women. Thus anemia represents an emerging global health problem producing a negative impact in the quality of life among the elderly and requiring greater allocation of health resources. AIM OF THE STUDY: To identify elderly patients with anemia and study the etiology, clinical parameters, laboratory parameters in these patients. METHODS: The cases received in the hematology department for peripheral smear reporting were screened and 100 cases that showed hemoglobin levels lower than standard WHO values were chosen. The entire medical history was obtained from each of the cases including previous medical reports and imaging studies. Blood samples were collected from all patients in plain vacutainers and EDTA containing vacutainers. Complete blood counts for all the samples was done using SYSMEX 3 part differential analyzer and the RBC indices was noted along with total WBC count, differential count, platelet count and hematocrit. ESR for all cases was done using Westergren tube. Peripheral smears were made for all the samples and stained using Leishman stain. Supravital staining using methylene blue was done for reticulocyte counting. Ferritin, iron and TIBC for all samples was done using SPINREACT kits for all the three and values obtained using colorimetric methods. The results obtained by the above tests was analyzed and the different etiologies, clinical features, intensity of anemia, peripheral smear picture and iron parameters were studied and compared with other studies. RESULTS: Among the etiologies, iron deficiency anemia was seen in 43% of patients, anemia of chronic disease in 32%, anemia of chronic kidney disease and unexplained anemia in 11 % each and 1 case β thalassemia. Among clinical features the commonest symptom was easy fatiguability and commonest sign was pallor. Peripheral smear study showed that normocytic normochromic anemia was commonest type. CONCLUSION: This study showed that the commonest cause for anemia among elderly patients is iron deficiency anemia followed by anemia due to chronic disease and also that it can be asymptomatic which is incidentally stumbled upon when one is evaluated for other symptoms. Not many clinical signs are consistent with anemia except for pallor even which can be absent in cases of mild anemia. Even though iron deficiency anemia is the commonest cause the peripheral smear studies in this study showed that normocytic normochromic picture was the commonest even when MCV levels were suggestive of microcytic anemia. Geriatric anemia is a disease that often goes unreported hence every effort should be made to identify the disease and evaluate the cause and it should not be ignored as merely being a part of ageing, for the consequences of anemia can have higher morbidity in the elderly.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Geriatric anemia ; Anemia in elderly ; Iron deficiency ; Iron Parameters; Peripheral smear.
Subjects: MEDICAL > Pathology
Depositing User: Laksham S
Date Deposited: 13 Jul 2017 09:26
Last Modified: 26 Nov 2018 17:19
URI: http://repository-tnmgrmu.ac.in/id/eprint/1642

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