In western countries, about half of the hospitalized patients are anemic. Generally, these patients are old, often with multiple diseases, and anemia worsens the prognosis, finally increasing the risk of death. We describe a monocentric observational study that evaluates 249 consecutive adult patients (160 women and 89 men) with anemia admitted in the internal medicine department over five months. They represent 71.5% of all patients admitted in the study period. Demographic, historical, and clinical data, laboratory tests, duration of hospitalization, readmission at 30 days, and death were recorded. Patients were stratified by age (75-84=old, >85 years=oldest-old), anemia severity, and etiology of anemia. Anemia was found in 67.5% of old and in 77.2% of oldest-old patients. In 37% of old and 32% of oldest-old patients, anemia was mild, in 43% old and 59% of oldest-old moderate and in 20% old and 9% of oldest-old severe in agreement with WHO criteria. Moderate anemia was significantly more common in the oldest-old (p=0.01). The causes of anemia were iron deficiency in 10.6% of patients, other deficiencies in 2.8%, chronic diseases in 38.2%, hematologic neoplasms in 6.1%, multifactorial in 24.1%, and undetermined in 19.9%. The oldest-old have a higher frequency of multifactorial anemia (p=0.04), while hematologic neoplasms were more common in old patients (p=0.03). Most patients with undetermined anemia had mild/moderate forms. An anti-anemic treatment, mainly blood transfusion, was adopted in 100% of oldest-old patients and in 60% of old (p= 0.04). Anemia (and/or its treatment) was reported in the discharge letter in 19% of old and in 28.2% of oldestold patients. From a general point of view, physicians seem to disregard anemia in the context of more important pathologic conditions. In oldest-old patients, multifactorial anemia seems to be considered only "one more cause of disability." When borderline anemia occurs, even if it can represent a relevant adverse condition in frailty, it is poorly considered.

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内科住院的高龄患者：贫血怎么办？

在西方国家，大约一半的住院患者患有贫血。一般来说，这些患者年龄较大，往往患有多种疾病，贫血使预后恶化，最终增加死亡风险。我们描述了一项单中心观察性研究，该研究对 5 个月内在内科收治的 249 名连续成年贫血患者（160 名女性和 89 名男性）进行了评估。他们占研究期间收治的所有患者的 71.5%。记录人口统计、历史和临床数据、实验室检查、住院时间、30 天再入院和死亡情况。根据年龄（75-84=老年，>85岁=最年长）、贫血严重程度和贫血病因对患者进行分层。67.5% 的老年人和 77.2% 的高龄患者患有贫血。与 WHO 标准一致，37% 的老年人和 32% 的高龄患者为轻度贫血，43% 的老年人和 59% 的高龄患者为中度贫血，20% 的老年人和 9% 的高龄患者为重度贫血。中度贫血在最年长的老年人中更为常见（p=0.01）。10.6%的患者贫血原因为缺铁，2.8%为其他缺乏症，38.2%为慢性疾病，6.1%为血液肿瘤，24.1%为多因素，19.9%为不明原因。年龄最大的老年人多因素贫血的发生率较高（p=0.04），而血液肿瘤在老年患者中更为常见（p=0.03）。大多数患有不明贫血的患者为轻度/中度贫血。100%的高龄患者和60%的老年人采用了主要是输血的抗贫血治疗（p=0.04）。出院信中报告了 19% 的老年人和 28.2% 的高龄患者贫血（和/或其治疗）。从一般角度来看，医生似乎在更重要的病理状况下忽视了贫血。在年龄最大的患者中，多因素贫血似乎被认为只是“残疾的又一个原因”。当发生边缘性贫血时，即使它可能代表虚弱的相关不良状况，也很少被考虑。