Anemia at outpatient and hospital stages

Anemia is one of the most common pathologies in patients of different age. The analysis of the incidence of different pathogenetic variants of anemia, discussion of the reasons for their late detection and insufficient treatment efficacy are aimed at improving the tactics of managing patients with anemia both at the outpatient and hospital stages.

The aim: to assess the incidence and severity of laboratory-confirmed anemia in patients observed at the outpatient and hospital stages.

Material and methods. A retrospective cross-sectional analysis of hemoglobin levels over the course of a year was performed using the continuous sampling method in the population (n = 260,000) aged 18 to 95 years attached to Diagnostical Clinical Center No. 1 of the Department of Healthcare of Moscow and in patients aged 19 to 96 years with anemia hospitalized in therapeutic department of the hospital.

Results. Laboratory criteria of anemia were registered in 5.9% of outpatients: in 1.5% of male individuals and 4.4% of female (p = 0.280), with the maximum incidence at the age of ≥ 75 years. Hemoglobin level in males was 116 ± 13.4 g/l, in females – 108 ± 11.5 g/l. Mild anemia was most often recorded in all age groups. Upon admission to the hospital, anemia was assessed as severe in 80.7% of patients, mild in 13.8%, and moderate in 5.5%. Among the different types of anemia, iron deficiency was predominant (72.2%), less common were vitamin B₁₂ deficiency (12%) and anemia of chronic disease (13.1%). The cause of anemia was determined in 79.7% of cases, mainly it consisted of malignant neoplasms (41.4%).

Conclusion. In outpatient practice, the incidence of anemia in the adult population was 5.9%, in hospital practice – 39.7%. Outpatients were more likely to have mild anemia in all age groups, while hospitalized patients had severe anemia (80.7%). A high proportion of patients with malignant neoplasms was revealed, possibly due to low oncological alertness of the physician and the reluctance of patients to undergo necessary examinations.