Investigation Of Anemia Associated Factors In Hospitalized Elderly Patients With Chronic Obstructive Pulmonary Disease

Objective:Chronic obstructive pulmonary disease(COPD),is a disease associated with the chronic inflammatory response of the respiratory system.Due to the continuous deterioration of lung function,the activity and life quality of patients are seriously reduced.It has the characteristics of high morbidity,high disability and high mortality.According to statistics,by the end of 2014,The population of 60 years old and above has reached 212 million people in China,accounting for 15.5% of the total population.The aging of China has come to the peak in advance.At the same time,the proportion of medical resources used by the elderly is also greatly improved,which brings heavy financial burden to the society and families.The various chronic diseases that affect the health of the elderly have become serious public health problems.The incidence of chronic obstructive pulmonary disease is mostly in middle-aged and elderly people.Studies have shown that the mortality rate of patients with chronic obstructive pulmonary disease increases with age.Chronic obstructive pulmonary disease can have many other complications at the same time,causing serious adverse effects on the prognosis of the patients.Currently,the most common complications include cardiovascular disease,lung cancer,infection,anemia,pulmonary embolism,osteoporosis,diabetes,metabolic syndrome,anxiety and depression.The traditional view is that long-term hypoxia and other reasons will cause the compensatory increase of RBC in patients with chronic obstructive pulmonary disease.However,in recent years,more and more studies have shown that anemia is not uncommon in patients with chronic obstructive pulmonary disease.Studies have shown that anemia can aggravate the prognosis of patients with chronic obstructive pulmonary disease and increase the mortality of the patients.In this study,the clinical data of the elderly patients of COPD inpatients were retrospectively analyzed,aimed to investigate the prevalence of chronic obstructive pulmonary disease in elderly patients with anemia and the related factors affecting the anemia of chronic obstructive pulmonary disease in the elderly.A certain extent,it provides a new theoretical basis for the early intervention of the elderly patients with chronic obstructive pulmonary disease with anemia.Methods:A retrospective study of the subject.In the medical records management department,the data of 536 elderly patients with chronic obstructive pulmonary disease admitted to respiratory department of Chengde Central Hospital from January 2012 to December 2016 were collected.The basic information of the patient’s sex,age,height,weight(BMI),smoking history,and the number of days in hospital were recorded.And record the first blood routine in the hospital: white blood cell count(WBC),red blood cell count(RBC),mean corpuscular hemoglobin concentration(MCHC),mean corpuscular volume(MCV),hemoglobin(Hb),platelet count(PLT),neutrophil percentage(N%),arterial blood gas analysis: oxygen partial pressure(Pa O2),pulmonary function: FEV1/FVC,FEV1%,biochemical index: total protein(TP),serum albumin(ALB),total cholesterol(TC),triglyceride(TG)and laboratory test index.According to the concentration of hemoglobin,the elderly patients with chronic obstructive pulmonary disease were divided into anemia group and non anemia group,and the above data were statistically analyzed with SPSS22.0 software.The prevalence rate of anemia in elderly patients with chronic obstructive pulmonary disease in our hospital was statistically analyzed,and the prevalence rate of anemia in patients with different sexes was statistically analyzed.The difference between of the above clinical indicators in two groups was compared,The measurement data are expressed in ±S,count data were compared by x2 test.The independent risk factors of chronic obstructive pulmonary disease associated with anemia in the elderly were screened by multiple regression analysis of Logistic with statistical significance.All the parameters were statistically significant with the difference of P < 0.05.Results:1.A retrospective study of 536 elderly patients(over 60 years)in patients with COPD,the anemia group of 128 cases,408 cases of non anemia group,anemia prevalence ratio of 31.37%.Among 536 elderly patients with chronic obstructive pulmonary disease,302(56.34%)were male,79 were male anemia,19 were hyperhemoglobin,and the prevalence rate of male anemia was 26.16%.Among 536 elderly patients with chronic obstructive pulmonary disease,234 were female(43.66%),49 were female anemia,11 were hyperhemoglobin,and the prevalence of female anemia was 20.94%.In addition,among the male and female anaemia with chronic obstructive pulmonary with anemia,mild anemia was the most common.2.Comparison of red blood cell parameters in two groups of patients,anemia group of patients with less RBC,Hb level is low,the difference is statistically significant(P < 0.01),two groups of MCHC,MCV,the difference was not statistically significant(P > 0.05).It is suggested that most of the elderly patients with chronic obstructive pulmonary disease with anemia are positive cell positive pigmented anemia.3.The above clinical data which may affect the chronic obstructive pulmonary disease with anemia are analyzed.The results showed that the age of anemia group was larger and the days of hospitalization were longer.The two groups of ALB,TC,TG,N% and Pa O2 were statistically significant(P < 0.05),which were the influencing factors of chronic obstructive pulmonary disease complicated with anemia.There was no significant difference in PLT between the two groups(P > 0.05).4.The six variables of statistical significance,such as age,number of days in hospital,ALB,TC,TG,N% were included in the multivariate regression analysis of Logistic.The results showed that age,number of days in hospital,ALB,TC and N% were independent risk factors for chronic obstructive pulmonary disease with anemia.(P < 0.05).Conclusion:1.Elderly patients with chronic obstructive pulmonary disease with anemia have a higher incidence,and more men than women,which is helpful for the majority of clinicians to pay attention to chronic obstructive pulmonary disease with anemia.2.The elderly patients with chronic obstructive pulmonary disease with anemia are mostly positive cell positive pigmented,and mild anemia is the most common.It can provide a new basis for the treatment of elderly patients with chronic obstructive pulmonary disease with anemia in the future.3.Age,hospitalization days,ALB,TC,TG,N%and Pa O2 were the influencing factors in the elderly COPD with anemia.Age,hospitalization days,ALB,TC and N% are the independent risk factors for the elderly patients with chronic obstructive pulmonary disease with anemia.Therefore,for elderly patients with chronic obstructive pulmonary disease,we can help clinicians to intervene early in elderly patients with chronic obstructive pulmonary disease with anemia through routine measurement and evaluation of their age,inflammatory response and nutritional status,in order to reduce their mortality.