- citati u SCIndeksu: [1]
- citati u CrossRef-u:0
- citati u Google Scholaru:[
 ]
- posete u poslednjih 30 dana:15
- preuzimanja u poslednjih 30 dana:2
|
|
|
2013, vol. 32, br. 2, str. 104-108
|
|
Anemija i anizocitoza u hitnoj službi - studija preseka
Anemia and anysocytosis in the emergency department: A cross-sectional investigation
aUnità Operativa Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero, Universitaria di Parma, Italy bUnità Operativa Pronto Soccorso e Medicina d'Urgenza, Azienda Ospedaliero, Universitaria di Parma, Italy
e-adresa: glippi@ao.pr.it, ulippi@tin.it
Sažetak
Uvod: Anemija predstavlja problem javnog zdravstva i povezana je s porastom morbiditeta i mortaliteta. Neke studije istražile su učestalost anemije u pedijatrijskim hitnim službama, ali takve informacije nisu dostupne za odrasle pacijente primljene na odeljenja za hitnu pomoć. Metode: Ispitivanu populaciju činili su odrasli pacijenti primljeni na odeljenje hitne pomoći Akademske bolnice u Parmi tokom 2010. godine s jednom od pet najčešćih patologija (akutni infarkt miokarda, AIM), bubrežne kolike, pneumonija, pankreatitis i teške povrede). Bolnički podaci preuzeti su iz informatičke baze podataka u skladu sa šifrom ICD-9 i srodnim terminima. Rutinsko hematološko testiranje izvršeno je na čitavoj populaciji pomoću identičnog instrumenta. Rezultati: Populaciju u ovoj studiji činilo je 462 pacijenata sa odeljenja za hitnu pomoć (slučajevi; 262 bubrežne kolike, 62 pneumonija, 51 akutni pankreatitis, 46 AIM i 41 teške povrede) i 429 zdravih davalaca krvi (kontrola). Srednja vrednost hemoglobina bila je značajno niža kod svih pacijenata u odnosu na kontrolne subjekte (137 prema 151 g/L; p<0,01), dok je srednja vrednost eritrocita bila značajno viša (13,7 prema 13,4%; p<0,01). Učestalost anemije i anizocitoze bila je veća kod pacijenata nego kod kontrolnih subjekata (anemija: 23 prema 4%, p<0,01; anizocitoza: 25 prema 16%, p=0,03). Vrednosti hemoglobina u svim potklasama pacijenata bile su značajno niže nego kod kontrolnih subjekata, dok su vrednosti eritrocita bile značajno povišene kod pacijenata sa AMI, pankreatitisom i pneumonijom. Zaključak: Utvrdili smo da postoji visoka prevalenca anemije i anizocitoze u populaciji pacijenata u hitnoj službi, čija identifikacija može biti presudna za odgovarajuće lečenje i potonji tretman.
Abstract
Background: Anemia is a public healthcare problem, which is associated with increased morbidity and mortality. Some studies assessed the frequency of anemia in pediatric emergency departments (EDs), but no such information is available in adult patients admitted to the ED. Methods: The study population consisted of adult patients admitted to the ED of the Academic Hospital of Parma during the year 2010 with the five most frequent acute pathologies (i.e., acute myocardial infarction, AMI), renal colics, pneumonia, pancreatitis and major trauma). Hospital records were extracted from informatics database according to ICD-9 code and related terms. Routine hematological testing was performed on the entire population with identical instrumentation. Results: The study population consisted of 462 ED patients (cases; 262 renal colics, 62 pneumonia, 51 acute pancreatitis, 46 AMI and 41 major trauma) and 429 healthy blood donors (controls). The median hemoglobin value was significantly lower in all patients than in controls (137 versus 151 g/L; p<0.01), whereas the median RDW value was significantly higher (13.7 versus 13.4%; p<0.01). The frequency of anemia and anysocytosis was higher in patients than in controls (anemia: 23 versus 4%, p<0.01; anysocytosis: 25 versus 16%; p=0.03). Hemoglobin values of all subclasses of patients were significantly lower than those of the controls, while those of RDW were significantly increased in patients with AMI, pancreatitis and pneumonia. Conclusions: We found a high prevalence of anemia and anysocytosis in a population of ED patients, whose identification may be vital for appropriate therapy and subsequent management.
|
|
|
|
Reference
|
|
  
|
Alexander, K.P., Chen, A.Y., Wang, T.Y., Rao, S.V., Newby, K.L., la Pointe, N., Allen, M., Ohman, M.E., Roe, M.T., Boden, W.E., Harrington, R.A., Peterson, E.D. (2008) Transfusion practice and outcomes in non-ST-segment elevation acute coronary syndromes. American heart journal, 155(6): 1047-53
|
|
|
Bassand, J., Afzal, R., Eikelboom, J., Wallentin, L., Peters, R., Budaj, A., Fox, K.A.A., Joyner, C.D., Chrolavicius, S., Granger, C.B., Mehta, S., Yusuf, S. (2010) Relationship between baseline haemoglobin and major bleeding complications in acute coronary syndromes. European heart journal, 31(1): 50-8
|
|
|
Culleton, B.F., Manns, B.J., Zhang, J., Tonelli, M., Klarenbach, S., Hemmelgarn, B.R. (2006) Impact of anemia on hospitalization and mortality in older adults. Blood, 107(10): 3841-6
|
|
|
Ershler, W.B., Chen, K., Reyes, E.B., Dubois, R. (2005) Economic burden of patients with anemia in selected diseases. Value in health, 8(6): 629-38
|
|
|
Hasin, T., Sorkin, A., Markiewicz, W., Hammerman, H., Aronson, D. (2009) Prevalence and prognostic significance of transient, persistent, and new-onset anemia after acute myocardial infarction. American journal of cardiology, 104(4): 486-91
|
|
|
Kristinsson, G., Shtivelman, S., Hom, J., Tunik, M.G. (2012) Prevalence of occult anemia in an urban pediatric emergency department: what is our response?. Pediatric emergency care, 28(4): 313-5
|
|
|
Lippi, G., Franchini, M. (2011) Troubleshooting anaemia in the elderly. Blood Transfus, 9: 110-11
|
|
1
|
McLean, E., Cogswell, M., Egli, I., Wojdyla, D., de Benoist, B. (2009) Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutrition, 12(04): 444
|
|
|
Mekky, M., Jasuja, M., Parkin, P.C. (2009) Moderate and Severe Microcytic Anemia in the Emergency Department: Indicators of Care. Clinical Pediatrics, 48(9): 902-903
|
|
|
Montagnana, M., Cervellin, G., Meschi, T., Lippi, G. (2012) The role of red blood cell distribution width in cardiovascular and thrombotic disorders. Clinical chemistry and laboratory medicine, 50(4): 635-41
|
|
|
Nissenson, A.R., Goodnough, L.T., Dubois, R.W. (2003) Anemia: not just an innocent bystander?. Archives of internal medicine, 163(12): 1400-4
|
|
1
|
Sabatine, M.S., Morrow, D.A., Giugliano, R.P., Burton, P.B.J., Murphy, S.A., McCabe, C.H., Gibson, M.C., Braunwald, E. (2005) Association of hemoglobin levels with clinical outcomes in acute coronary syndromes. Circulation, 111(16): 2042-9
|
|
|
Thavendiranathan, P., Bagai, A., Ebidia, A., Detsky, A.S., Choudhry, N.K. (2005) Do blood tests cause anemia in hospitalized patients? The effect of diagnostic phlebotomy on hemoglobin and hematocrit levels. Journal of general internal medicine, 20(6): 520-4
|
|
|
|
|