Analysis Of Inter-departmental Differences In The Diagnosis And Treatment Of Inpatients With Elderly Anemia

Objective:Anemia is common in the elderly,and with the development of aging society,the number of elderly patients with anemia may increase dramatically in the coming years.Studies have found that the incidence of anemia in hospitalized elderly patients is significantly higher than the average.Any degree of anemia in the elderly may be an independent factor for its illness,weakness,and death.This article collects clinical data of elderly patients hospitalized in some departments,analyzes the characteristics,department distribution and diagnosis of elderly patients with anemia,and then observes the hospitalization of these patients over a period of time.Based on the current research progress,explore the relationship between senile anemia and common chronic diseases,and provide a reference for clinical selection of the timing of prevention and treatment of anemia.Methods:We retrospectively collected clinical data of 1021 elderly patients over 60 years of age who were admitted to the department of hypertension,respiratory medicine,endocrinology,and gastroenterology of The First Affiliated Hospital of Dalian Medical University between January 2016 and March 2016.Then observe the re-hospitalization in our hospital before December 2018,including gender,age,consultation department,blood routine test results,number of hospitalizations,anemia and death diagnosis.Only the first and last blood test results were collected for multiple hospitalizations of the same patient.We selected general clinical data and laboratory indicators to count the incidence of anemia and the diagnosis rate of elderly patients in various departments,and observed and analyzed changes in laboratory indicators of re-hospitalized patients during the study period.Routine blood tests include Hemoglobin(HB),Red Blood Cell(RBC),Mean Cell Volume(MCV),Mean Cell Hemoglobin(MCH),and Mean Cell Hemoglobin Concentration(Mean Cell Hemoglobin Concentration(MCHC).Statisticalanalysis was performed on all data with Excel and SPSS22.0.The normality and homogeneity of the data are tested.Data that meet the normal distribution and homogeneity of variance are compared multiplely using analysis of variance and Tukey’s test.Non-parametric tests are used for data that do not meet the normal distribution.The correlation between variables was analyzed by Logistic regression.P<0.05 was statistically significant.Results: According to the inclusion and exclusion criteria,1021 elderly patients were hospitalized,including 224 in the hypertension department,323 in the respiratory medicine department,152 in the endocrinology department,and 322 in the department of gastroenterology.With the increase of age,the level of HB decreased with statistical significance(P<0.05).The HB level of patients in different departments was the highest in the department of hypertension and the lowest in the department of respiratory medicine.The difference was statistically significant(P<0.05).Comparing the ages of different departments,there were statistically significant differences between the department of hypertension and respiratory medicine,gastroenterology,respiratory medicine,endocrinology and gastroenterology(P <0.05).Of the 1021 patients,144 were anemia,of which 15 were in the department of hypertension,59 in the department of respiratory medicine,23 in the department of endocrinology,and 47 in the department of digestive medicine.The incidence of anemia in elderly hospitalized patients was 14.1%,and the incidence of anemia in men(16.5%)was higher than that in women(11.7%).The distribution of anemia patients in different age groups and departments was statistically significant(P<0.05).There were statistically significant differences in the age and incidence of anemia among different departments(P<0.05).There was a statistically significant difference in the incidence of anemia between genders in different departments and departments of hypertension(P<0.05),and there was a statistically significant difference in the diagnosis rate of anemia among different genders in respiratory medicine(P<0.05).Of the 1021 patients,373 were re-hospitalized,and the re-hospitalization rate was36.5%.The distribution of anemia patients and non-anemia patients in there-hospitalization department was statistically significant(P<0.05).The difference in HB levels between the two hospitalized patients was statistically significant(P<0.05).There was a statistically significant difference in HB between two hospitalizations of different genders among non-anemic patients(P<0.05).Of the 1021 patients,17 died,with a mortality rate of 1.7%.There was a statistically significant difference in mortality between patients with anemia and non-anemia between different genders(P<0.05).The main causes of death were circulatory failure and respiratory failure.Conclusion: Hypertension patients have a low incidence of anemia and the highest risk of cardiovascular death.Respiratory medicine patients have a high incidence of anemia,but a low diagnosis rate,the highest rate of re-hospitalization,and a higher risk of death.Gastroenterological anemia patients are younger,but the re-hospitalization rate is second only to respiratory medicine.In short,the incidence of anemia in elderly hospitalized patients is high,positively related to age,and closely related to the re-hospitalization rate and mortality of chronic diseases,but each department lacks attention in the diagnosis and treatment of anemia.In addition to actively treating specialist diseases,clinicians should strengthen their understanding of anemia in the elderly,attach importance to early treatment to improve the quality of life of patients.