Falls in anaemic and non-anaemic hospitalized elderly patients in 2012-2016 - mutual relationships.

Although falls are more prevalent as ageing proceeds, it cannot be assumed that they happen due to ageing alone. The retrospective cohort study of data was targeted to make an analysis of prevalence of falls in anaemic patients in comparison to the non-anaemic elderly admitted to the acute geriatric department and evaluation of pertinent influence of age, gender and immobility on occurrence of falls. During the considered period of four years (2012-2016) the authors treated 9 363 elderly patients aged 79,9±8,6 years (in the majority of them 65+ years). Among them there were 8 809 non-anaemic and subgroup of 551 old anaemic patients (aged 81±7 years) with decreased haemoglobin (<110 g/l). Falls at hospital admission in average was present in 1 766 non-anaemic persons (20%) in comparison to 380 falls among anaemic patients (68,6%). Prevalence in anaemic subgroup is statistically significant higher (p<0,005). Also relation between falls and age, ADL and MMSE test and mobility is highly statistically significant (p<0,001). Meaningfully higher is occurrence of repeated falls in the anaemic subgroup in comparison to the non-anaemic one (41,2 vs 1,7%). The occurrence of falls in female gender in comparison to men is statistically significant higher in non-anaemic patients, not in anaemic group. Authors emphasize that anaemia appears to us as significant risk factor for falls in the elderly.

Anemia in elderly an important diagnostic and therapeutic problem in geriatric medicine.

Although anemia is more prevalent as aging proceeds, it cannot be assumed that it happens due to aging alone. The biggest prevalence of anemia is in the oldest old who are hospitalized. An analysis of occurrence and charactertistics of anemia in the elderly 65+ y. admitted to acute geriatric department. During the period of two years the authors treated 2282 elderly patients aged 65+ y. Out of them a subgroup of 246 old anemic patients with hemoglobin <110 g/I (aged 81+/- 7.2 y.) was selected. The prevalence of anemic patients among all the acutely admitted seniors ranged between 7.1% and 20% (from 65 y. to 100 y.). All the data of these anemic patients (both clinical and laboratory) were collected and analyzed. Hemoglobin by hospital admission in average was 93.4 g/l +/- 12.9; below 80 g/l in 56 cases. The authors found anemic persons living lonely in the community more frequently (p = 0.005) than in elderly people living with somebody or in an institution. No significant gender differences in the occurrence of anemia were observed. MCV (Microtic Cell Volume) was normal in 73% of patients; below 80 fl in 23% and above 100 fl in 4% of all anemic patients. Low iron level though was present in 192-times (78%). Low zinc level was together in this anemic patient set present in 222 cases (90.2%). During hospitalization the status was as follows: worsened 18-times; stationary 160-times and significantly improved 68-times. Anemia in the elderly is often caused by a benign disease and, in fact, may simply be a marker of a chronic illness. It may be, however, a presenting sign of a serious disease, including cancer. The authors point out some aspects, risks and pitfalls of anemia in the elderly following their own experiences concerning anemia as a chronic disease.

Importance of blood clotting tests in the diagnosis of haemolytic-uremic syndrome and experience with its treatment.

More than half of 33 children with HUS were less than a year old, 90% less than five. A constant laboratory finding was the presence of FDP in the blood and urine, and of the remaining tests the presence of erythrocyte fragments. The absence of thrombocytopenia does not eliminate HUS. Antiplatelet treatment was given to 94% of children, heparin to 94%, thrombolysis to 27% Precise evaluation of treatment would require a controlled prospective multicentre study.