Anaemia in elderly patients at discharge from intensive care and hospital

Anaemia is common in the elderly and is recognized as a risk factor for several adverse outcomes in older adults, including hospitalization, morbidity and mortality. The study aims were to examine the prevalence of anaemia in elderly patients at discharge from the intensive care unit (ICU) and hospital.

Patient randomized under the INFORM trial and with an ICU admission were included. Two cohorts, Cohort 1 patients who were alive on discharge from ICU and Cohort 2 patients who were discharged alive from hospital to home. Prevalence of significant anaemia defined as haemoglobin levels, less than 100 g/l was measured at ICU and hospital discharge.

Overall, 76·5% (683/893) of elderly admissions in Cohort 1 had a haemoglobin <100 g/l, and 44·1% (395/893) had a haemoglobin <90 g/l on ICU discharge. Nadir haemoglobin during ICU stay, length of stay in ICU and transfusion during ICU stay was associated with significant anaemia at ICU discharge. At hospital discharge, in Cohort 2, 54·8% (263/480) of elderly ICU admissions had Hb < 100 g/l, and 23·4% (112/480) had Hb < 90 g/l. Male gender, haemoglobin level at ICU discharge, and length of stay and nadir Hb between ICU and hospital discharge were associated with anaemia at hospital discharge.

Significant anaemia is highly prevalent in elderly patients on discharge from ICU and to a lesser degree at hospital discharge.