Öz
Aim: This
study aims to investigate the frequency and morphologic distribution of anemia
and the relationship of anemia with socio-demographic variables, the state of
chronic disease, and drug use in the patients at the age of 65 and older who
have been receiving home care service. Method:
This cross-sectional was carried out between August 2011 and September 2012 and
the study population involved 194 patients aged 65 years or older without a
terminal disease. Socio-demographic data form, which was standardized for home
care services by the Ministry of Health was employed and laboratory data were
investigated by patient files. The presence of Anemia was evaluated in
accordance with the definition of WHO. Results:
Total 194 persons, 121 women and 73 men with ages ranging from 65 to 104 were
included in the study. The mean age is 75,0±16,0 years. 58.2% (113) of the
cases involved in the study were diagnosed with anemia. Of the anemic cases
18.6%(n=21) were hypochromic, 78.8% (n=89) were normochromic, and 2.7% (n=3) macrocytic
anemia. Sedimentation rate and CRP level of the patients with anemia were
significantly higher than those of without anemia (p>0.05). The rate of
being bedridden and of using a bed with an air-bearing pad of the anemic cases
were also statistically significantly higher than that of without anemia
(p<0,05). Regarding MCV classification for patients with anemia, the mean of
medication intake, CRP measurement values, use of bed with air-bearing pad, the
frequency of neurological diagnosis was found out to be significantly higher in
normochromic group cases in comparison to hypochromic and macrocytic group
cases (p>0.05). Conclusion:
Anemia is quite common in the elderly benefitting from home health care
services and the vast majority has the anemia of chronic disease, inflammation
induced anemia or unexplained anemia. Iron deficiency is the most important and
the most frequent one among nutritional anemias. The evaluation of elderly
patients receiving home care services in terms of anemia is important to give
appropriate treatment that will positively affect their quality of life and it
will also hinder the complications associated with anemia
Amaç: Evde sağlık hizmeti almakta olan 65 yaş ve üstü hastalarda anemi sıklığı
ve morfolojik dağılımı ile anemi ilişkisinin sosyodemografik değişkenler,
kronik hastalık durumu ve ilaç kullanımı ile ilişkisi araştırılması. Bu kesitsel
çalışma, Ağustos 2011 ile Eylül 2012 arasında gerçekleştirildi. Çalışma
popülasyonu, 65 yaş ve üzeri, terminal hastalığı olmayan Evde sağlık birimine
kayıtlı 194 hasta ile yapıldı. Sağlık Bakanlığı tarafından evde sağlık
hizmetleri için standardize edilen sosyo-demografik veri formu ve laboratuvar
verileri kullanıldı. Anemi varlığı WHO'nun tanımına göre değerlendirildi. Bulgular: Çalışmaya toplam 194 kişi,
yaşları 65 ile 104 arasında değişen 121 kadın ve 73 erkek alındı. Yaş
ortalaması 75,0 ± 16,0'dır. Çalışmaya dahil edilen kişilerin % 58.2'si (113)
anemiyle teşhis edildi. Anemik olguların%18.6'sı (n = 21) hipokrom, %78.8'i (n = 89) normokrom,
%2.7'si (n = 3) makrositik anemi idi. Anemili hastaların sedimentasyon hızı ve
CRP düzeyi anemisi olmayanlara göre daha yüksek bulundu (p> 0.05). Anemik
olguların hava yastığı ile yatak yatağı kullanma ve yatak başı olma oranı da
anemi olmaksızın istatistiksel olarak anlamlı derecede yüksekti (p <0,05).
Anemi hastaları için MCV sınıflaması ile ilgili olarak, hipokromik grup ve
makrositik grup vakalarına kıyasla normokromik grup olgularında ilaç alımı
ortalaması, CRP ölçüm değerleri, hava yastığı ile yatak kullanımı, nörolojik
tanı sıklığı anlamlı olarak daha yüksek bulundu (p <0.05). Sonuç: Evde sağlık hizmetlerinden
yararlanan yaşlılarda demir eksikliği anemisini oldukça yaygındır ve büyük
çoğunluğu kronik hastalık, inflamasyon, GİS malignite veya açıklanamayan
anemiye sahiptir. Demir eksikliği, nutrisyonal anemiler arasında en önemli ve
en sık görülenidir. Yaşlıların anemi açısından değerlendirilmesi, yaşam kalitesini
olumlu yönde etkileyebilecek uygun bir tedavi sağlanması açısından önemlidir ve
aynı zamanda anemi ile ilişkili komplikasyonları da engelleyecektir.
Anahtar Kelimeler
Kaynakça
- Referans 1Joosten E, Pelemans W, Hiele M, Noyen J, Verhaeghe R, Boogaerts MA(1992). Prevalence and causes of anaemia in a geriatric hospitalizedpopulation. Gerontology 38: 111-117.Referans 2 Türkiye İstatististik Kurumu www.tuik.gov.tr accessed in 15.04.2013.Referans 3 Erdogan S, Secginli S, Cosansu G, Nahcivan NO, Esin MN, Aktas E,Monsen KA (2013). Using the Omaha System to describe health problems,interventions, and outcomes in home care in Istanbul, Turkey: a studentinformatics research experience. Comput Inform Nurs.31(6):290-8. doi:10.1097/NXN.0b013e318282ealaReferans 4 Nissenson AR, Wade S, Goodnough T et al. (2005).Economic burden ofanemia in an insured population. J Manag Care Pharm11(7):565-574Referans 5 Berliner N (2013). Anemia in elderly. Trans Am Clin Climatol Assoc.124:230-7.Referans 6 Eisenstaedt R, Penninx BW, Woodman RC (2006). Anemia in the elderly:current understanding and emerging concepts. Blood Rev 20 (4): 213–26.Referans 7 Balducci L (2003). Epidemiology of anemia in the elderly: information ondiagnostic evaluation. J Am Geriatr Soc 51(3 Suppl):S2-9.Referans 8 Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, HemmelgarnBR (2006). Impact of anemia on hospitalization and mortality in olderadults. Blood 107(10):3841-6.Referans 9 Izaks GJ, Westendorp RG, Knook DL(1999). The definition of anemia inolder persons. JAMA 12;281(18):1714-7.Referans 10 Woodman R, Ferrucci L, Guralnik J (2005). Anemia in older adults. CurrOpin Hematol 12(2):123-8. Review.Referans 11 Gaskell H, Derry S, Moore RA, McQuay HJ(2008). Prevalence of anemia inolder persons: systematic review. BMC Geriatrics 8: 1 doi:10. 1186/1471-2318-8-1.Referans 12 Merchant AA, Roy CN (2011). Not so benign haematology: anaemia of theelderly. British Journal of Haematology156:173–185 doi: 10.1111/j. 1365-2141. 2011.08920.x.Referans 13 Pang WW (2012). Anemia in the elderly. Curr Opin Hematol. 19(3):133-40.doi: 10.1097/MOH.0b013e3283522471.Referans 14 Steensma DP, Tefferi A(2007). Anemia in the elderly: how should wedefine it, when does it matter, and what can be done? Mayo Clin Proc.82(8):958-966.Referans 15 Kolnaar BGM, Van Wijk MAM, Pijnenborg L, Assendelft WJJ (2003).Summary of the Dutch College of General Practitioners’ practice guideline“anaemia”. Ned Tijdschr Geneeskd. 147(40):1956-61.Referans 16 Smith DL (2000). Anemia in elderly.Am Fam Physician 62(7):1565-72.Referans 17 Killip S, Bennett JM, Chambers MD. Iron deficiency anemia. Am FamPhysician. 2007;75(5):671-8.Referans 18 De Marchi S, Pirisi M, Ferraccioli GF (1993). Erythropoietin and theanemia of chronic diseases. Clin Exp Rheumatol. 11(4):429-44.Referans 19 Chaves PH (2008). Functional outcomes of anemia in older adults. SeminHematol. 45(4):255-60.Referans 20 Dallman PR, Yip R, Johnson C (1984). Prevalence and causes of anemia inthe United States, 1976 to 1980. Am J Clin Nutr. 39: 437- 445.Referans 21 Salive ME, Cornoni-Huntley J, Guralnik JM, Phillips CL, Wallace RB,Ostfeld AM, Cohen HJ (1992). Anemia and hemoglobin levels in olderpersons: relationship with age, gender, and health status. J Am Geriatr Soc.40: 489-496.Referans 22 Chernetsky A, Sofer O, Rafael C, Ben-Israel J (2002). Prevalence andetiology of anemia in an institutionalized geriatric population. Harefuah141: 591-594.Referans 23 Coban E, Timuragaoglu A, Meric M (2003). Iron deficiency anemia in theelderly: prevalence and endoscopic evaluation of the gastrointestinal tract inoutpatients. Acta Haematol 110: 25-28.Referans 24 Coban E, Akın M,Aykut A, Timuragaoglu A (2004).Yaşlı HastalardaAnemi Sıklığı ve Morfolojik Dağılımı [Prevalance of anemia in elderliesand morphologic distribution] Turkish Journal of Geriatrics Türk GeriatriDergisi 7 (3): 131-132 .Referans 25 Beghé C, Wilson A, Ersler WB. Prevalance and outcomes of anemia ingeriatrics: A systematic review of the literature. Am J Med 116(7A): 3-10Referans 26 Beard CM, Kokmen E, O’Brien PC, Ania BJ, Melton LJ (1997). III. Risk ofAlzheimer’s disease among elderly patients with anemia: population basedinvestigations in Olmsted County, Minnesota. Ann Epidemiol. 7(3):219-24.Referans 27 Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC(2004).Prevalence of anemia in persons 65 years and older in the United States:evidence for a high rate of unexplained anemia. Blood 104(8):2263-2268.Referans 28 Clarke R, Refsum H, Birks J, et al (2003). Screening for vitamin B-12 andfolate deficiency in older persons. Am J Clin Nutr. 77(5):1241-7.Referans 29 Stabler SP (1995). Screening the older population for cobalamin (vitaminB12) deficiency. J Am Geriatr Soc. 43(11):1290-7.Referans 30 Andrès E, Loukili NH, Noel E, Kaltenbach G, Abdelgheni MB, Perrin AE,Noblet-Dick M, Maloisel F, Schlienger JL, Blicklé JF (2004). Vitamin B12cobalamin deficiency in elderly patients. CMAJ 3;171(3):251-9Referans 31 Den Elzen WP, Westendorp RG, Frolich M, de Ruijter W, Assendelft WJ,Gussekloo J (2008). Vitamin B12 and folate and the risk of anemia in oldage: the Leiden 85-Plus Study. Arch Intern Med. 168(20):2238-44.Referans 32 Den Elzen WP, van der Weele GM, Gussekloo J, Westendorp RG,Assendelft WJ (2010). Subnormal vitamin B12 concentrations and anaemiain older people: a systematic review. BMC Geriatr. 10:42.doi: 10.1186/1471-2318-10-42Referans 33 Hughes D, Elwood PC, Shinton NK, Wrighton RJ (1970). Clinical trial ofthe effect of vitamin B12 in elderly subjects with low serum B12 levels. BrMed J. 1(5707):458-60.Referans 34 Seal EC, Metz J, Flicker L, Melny J (2002). A randomized, double-blind,placebocontrolled study of oral vitamin B12 supplementation in olderpatients with subnormal or borderline serum vitamin B12 concentrations. JAm Geriatr Soc. 50(1):146-51.Referans 35 lark SF (2008). Iron deficiency anemia. Nutr Clin Pract23(2):128-41Referans 36 Guyatt GH, Oxman AD, Ali M, Willan A, McIlroy W, Patterson C (1992)..Laboratory diagnosis of iron-deficiency anemia: an overview. J Gen InternMed. 7(2):145-53.Referans 37 Lipschitz DA, Cook JD, Finch CA (1974). A clinical evaluation of serumferritin as an index of iron stores. N Engl J Med. 290(22):1213-6.Referans 38 Nemeth E, Rivera S, Gabayan V, Keller C, Taudorf S, Pedersen BK, et al(2004). IL-6 mediates hypoferremia of inflammation by inducing thesynthesis of the iron regulatory hormone hepcidin. J Clin Invest 113:1271–6.Referans 39 Den Elzen WP, Gussekloo J, Willems JM, et al (2010). Predictive value oflow ferritin in older persons with anemia with and without inflammation:the Leiden 85-plus Study. J Am Geriatr Soc58(8):1601-3.Referans 40 Den Elzen WP, Gussekloo J. Anemia in older persons (2011). Journal ofMedicine 9(6): 260-7.
Öz
Kaynakça
- Referans 1Joosten E, Pelemans W, Hiele M, Noyen J, Verhaeghe R, Boogaerts MA(1992). Prevalence and causes of anaemia in a geriatric hospitalizedpopulation. Gerontology 38: 111-117.Referans 2 Türkiye İstatististik Kurumu www.tuik.gov.tr accessed in 15.04.2013.Referans 3 Erdogan S, Secginli S, Cosansu G, Nahcivan NO, Esin MN, Aktas E,Monsen KA (2013). Using the Omaha System to describe health problems,interventions, and outcomes in home care in Istanbul, Turkey: a studentinformatics research experience. Comput Inform Nurs.31(6):290-8. doi:10.1097/NXN.0b013e318282ealaReferans 4 Nissenson AR, Wade S, Goodnough T et al. (2005).Economic burden ofanemia in an insured population. J Manag Care Pharm11(7):565-574Referans 5 Berliner N (2013). Anemia in elderly. Trans Am Clin Climatol Assoc.124:230-7.Referans 6 Eisenstaedt R, Penninx BW, Woodman RC (2006). Anemia in the elderly:current understanding and emerging concepts. Blood Rev 20 (4): 213–26.Referans 7 Balducci L (2003). Epidemiology of anemia in the elderly: information ondiagnostic evaluation. J Am Geriatr Soc 51(3 Suppl):S2-9.Referans 8 Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, HemmelgarnBR (2006). Impact of anemia on hospitalization and mortality in olderadults. Blood 107(10):3841-6.Referans 9 Izaks GJ, Westendorp RG, Knook DL(1999). The definition of anemia inolder persons. JAMA 12;281(18):1714-7.Referans 10 Woodman R, Ferrucci L, Guralnik J (2005). Anemia in older adults. CurrOpin Hematol 12(2):123-8. Review.Referans 11 Gaskell H, Derry S, Moore RA, McQuay HJ(2008). Prevalence of anemia inolder persons: systematic review. BMC Geriatrics 8: 1 doi:10. 1186/1471-2318-8-1.Referans 12 Merchant AA, Roy CN (2011). Not so benign haematology: anaemia of theelderly. British Journal of Haematology156:173–185 doi: 10.1111/j. 1365-2141. 2011.08920.x.Referans 13 Pang WW (2012). Anemia in the elderly. Curr Opin Hematol. 19(3):133-40.doi: 10.1097/MOH.0b013e3283522471.Referans 14 Steensma DP, Tefferi A(2007). Anemia in the elderly: how should wedefine it, when does it matter, and what can be done? Mayo Clin Proc.82(8):958-966.Referans 15 Kolnaar BGM, Van Wijk MAM, Pijnenborg L, Assendelft WJJ (2003).Summary of the Dutch College of General Practitioners’ practice guideline“anaemia”. Ned Tijdschr Geneeskd. 147(40):1956-61.Referans 16 Smith DL (2000). Anemia in elderly.Am Fam Physician 62(7):1565-72.Referans 17 Killip S, Bennett JM, Chambers MD. Iron deficiency anemia. Am FamPhysician. 2007;75(5):671-8.Referans 18 De Marchi S, Pirisi M, Ferraccioli GF (1993). Erythropoietin and theanemia of chronic diseases. Clin Exp Rheumatol. 11(4):429-44.Referans 19 Chaves PH (2008). Functional outcomes of anemia in older adults. SeminHematol. 45(4):255-60.Referans 20 Dallman PR, Yip R, Johnson C (1984). Prevalence and causes of anemia inthe United States, 1976 to 1980. Am J Clin Nutr. 39: 437- 445.Referans 21 Salive ME, Cornoni-Huntley J, Guralnik JM, Phillips CL, Wallace RB,Ostfeld AM, Cohen HJ (1992). Anemia and hemoglobin levels in olderpersons: relationship with age, gender, and health status. J Am Geriatr Soc.40: 489-496.Referans 22 Chernetsky A, Sofer O, Rafael C, Ben-Israel J (2002). Prevalence andetiology of anemia in an institutionalized geriatric population. Harefuah141: 591-594.Referans 23 Coban E, Timuragaoglu A, Meric M (2003). Iron deficiency anemia in theelderly: prevalence and endoscopic evaluation of the gastrointestinal tract inoutpatients. Acta Haematol 110: 25-28.Referans 24 Coban E, Akın M,Aykut A, Timuragaoglu A (2004).Yaşlı HastalardaAnemi Sıklığı ve Morfolojik Dağılımı [Prevalance of anemia in elderliesand morphologic distribution] Turkish Journal of Geriatrics Türk GeriatriDergisi 7 (3): 131-132 .Referans 25 Beghé C, Wilson A, Ersler WB. Prevalance and outcomes of anemia ingeriatrics: A systematic review of the literature. Am J Med 116(7A): 3-10Referans 26 Beard CM, Kokmen E, O’Brien PC, Ania BJ, Melton LJ (1997). III. Risk ofAlzheimer’s disease among elderly patients with anemia: population basedinvestigations in Olmsted County, Minnesota. Ann Epidemiol. 7(3):219-24.Referans 27 Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC(2004).Prevalence of anemia in persons 65 years and older in the United States:evidence for a high rate of unexplained anemia. Blood 104(8):2263-2268.Referans 28 Clarke R, Refsum H, Birks J, et al (2003). Screening for vitamin B-12 andfolate deficiency in older persons. Am J Clin Nutr. 77(5):1241-7.Referans 29 Stabler SP (1995). Screening the older population for cobalamin (vitaminB12) deficiency. J Am Geriatr Soc. 43(11):1290-7.Referans 30 Andrès E, Loukili NH, Noel E, Kaltenbach G, Abdelgheni MB, Perrin AE,Noblet-Dick M, Maloisel F, Schlienger JL, Blicklé JF (2004). Vitamin B12cobalamin deficiency in elderly patients. CMAJ 3;171(3):251-9Referans 31 Den Elzen WP, Westendorp RG, Frolich M, de Ruijter W, Assendelft WJ,Gussekloo J (2008). Vitamin B12 and folate and the risk of anemia in oldage: the Leiden 85-Plus Study. Arch Intern Med. 168(20):2238-44.Referans 32 Den Elzen WP, van der Weele GM, Gussekloo J, Westendorp RG,Assendelft WJ (2010). Subnormal vitamin B12 concentrations and anaemiain older people: a systematic review. BMC Geriatr. 10:42.doi: 10.1186/1471-2318-10-42Referans 33 Hughes D, Elwood PC, Shinton NK, Wrighton RJ (1970). Clinical trial ofthe effect of vitamin B12 in elderly subjects with low serum B12 levels. BrMed J. 1(5707):458-60.Referans 34 Seal EC, Metz J, Flicker L, Melny J (2002). A randomized, double-blind,placebocontrolled study of oral vitamin B12 supplementation in olderpatients with subnormal or borderline serum vitamin B12 concentrations. JAm Geriatr Soc. 50(1):146-51.Referans 35 lark SF (2008). Iron deficiency anemia. Nutr Clin Pract23(2):128-41Referans 36 Guyatt GH, Oxman AD, Ali M, Willan A, McIlroy W, Patterson C (1992)..Laboratory diagnosis of iron-deficiency anemia: an overview. J Gen InternMed. 7(2):145-53.Referans 37 Lipschitz DA, Cook JD, Finch CA (1974). A clinical evaluation of serumferritin as an index of iron stores. N Engl J Med. 290(22):1213-6.Referans 38 Nemeth E, Rivera S, Gabayan V, Keller C, Taudorf S, Pedersen BK, et al(2004). IL-6 mediates hypoferremia of inflammation by inducing thesynthesis of the iron regulatory hormone hepcidin. J Clin Invest 113:1271–6.Referans 39 Den Elzen WP, Gussekloo J, Willems JM, et al (2010). Predictive value oflow ferritin in older persons with anemia with and without inflammation:the Leiden 85-plus Study. J Am Geriatr Soc58(8):1601-3.Referans 40 Den Elzen WP, Gussekloo J. Anemia in older persons (2011). Journal ofMedicine 9(6): 260-7.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | İç Hastalıkları, Sağlık Kurumları Yönetimi |
| Bölüm | Orijinal Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 11 Mart 2019 |
| Gönderilme Tarihi | 4 Ağustos 2018 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 13 Sayı: 1 |
Cited By
Sağlığın ve birinci basamak bakımın anlaşılmasına ve geliştirilmesine katkıda bulunacak yeni bilgilere sahip yazarların İngilizce veya Türkçe makaleleri memnuniyetle karşılanmaktadır.