Evaluation of anaemia in geriatric patients: a retrospective hospital-based study from Northern Sri Lanka

Background: Anaemia in older adults is a common medical problem but it is often not evaluated as a sole clinical entity and its importance is undermined. The gravity of anaemia in older adults and its impact on other diseases is not well known in Sri Lanka. Methods: This was a cross-sectional descriptive study where data was extracted retrospectively from the database and clinical records of patients who were referred to the haematology unit of Teaching Hospital Jaffna, Sri Lanka for the evaluation of anaemia, from September 2020 to February 2021. The common types of anaemia, their severity, aetiological classifications and association with other diseases were analysed. Results: A total of 1121 medical records of patients above 60 years were analysed during the study period. The main source of referrals was from medical wards. The female to male ratio was 51.2:48.8.The majority belonged to the age group of 60-69 years. Two-third of the patients had normocytic anaemia (70.3%) followed by microcytic (23.7%) and macrocytic anaemia (6.0%). A moderate degree of anaemia was seen commonly, but 28.3% were found to have severe anaemia. Aetiological classification revealed anaemia of chronic disease as the commonest type of anaemia in older adults accounting for 37% of the study sample, followed by multifactorial aetiology and iron deficiency anaemia. Common chronic diseases identified along with anaemia were diabetes, hypertension, ischaemic heart disease and chronic kidney disease. Conclusions: Normocytic anaemia was the commonest type identified and the majority were of a moderate degree. Though the commonest aetiological cause identified is anaemia of chronic disease, there was a considerable percentage of multifactorial causes indicating the need to be on the lookout for other possibilities. Identifying the prevalence of anaemia in all hospitalised older adult patients in the local setting, the causes and the impact on chronic and acute illnesses will immensely help in the management of older adult patients and improve their quality of life.