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Significance of a low serum ferritin level in elderly in-patients
E Joosten1, L Dereymaeker, W Pelemans
1Division of Geriatric Medicine, University Hospitals, K.U. Leuven, Belgium.
Abstract:
Iron deficiency, defined as a serum ferritin level less than or equal to 50 micrograms/l was found in 28 (11%) of 252 consecutive elderly in-patients (mean age 81 years). Sixteen among them were anaemic and only five had a microcytic anaemia. In a separate study, 15 anaemic and 13 non-anaemic iron-deficient elderly in-patients were investigated in order to evaluate the prevalence of gastrointestinal symptoms and lesions in both groups. In nine of the anaemic and seven of the non-anaemic patients a potential cause for the iron deficiency was established. Most anaemic and non-anaemic patients lacked the symptoms described as suggestive of underlying gastrointestinal pathology. Thus, a ferritin level less than or equal to 50 micrograms/l justifies a gastrointestinal investigation if the general condition allows for it as well in anaemic as in non-anaemic elderly hospitalized patients. Therefore, serum ferritin should be part of the routine biochemical investigation of elderly in-patients.
Insights
Iron deficiency, indicated by serum ferritin levels ≤50 µg/L, affects 11% of elderly inpatients. Routine screening is recommended, as gastrointestinal investigations are warranted regardless of anemia status.
Area of Science:
- Geriatrics
- Hematology
- Gastroenterology
Background:
- Iron deficiency is common in elderly inpatients.
- Serum ferritin levels are a key indicator of iron status.
Purpose of the Study:
- To determine the prevalence of iron deficiency in elderly inpatients.
- To evaluate gastrointestinal symptoms and lesions in iron-deficient elderly patients, with and without anemia.
Main Methods:
- Serum ferritin levels were measured in 252 elderly inpatients.
- Iron-deficient patients (serum ferritin ≤50 µg/L) were further assessed for anemia and gastrointestinal pathology.
Main Results:
- Iron deficiency was found in 11% of elderly inpatients (n=28).
- Only 5 of the 16 anemic patients had microcytic anemia.
- Most iron-deficient patients, anemic or not, lacked typical gastrointestinal symptoms.
Conclusions:
- A serum ferritin level ≤50 µg/L warrants gastrointestinal investigation in elderly inpatients, irrespective of anemia.
- Serum ferritin measurement should be a routine part of biochemical investigations for elderly inpatients.