Anaemia: Diagnosis of iron deficiency anemia in the elderly
Clinical Bottom Line
In community dwelling elderly medical patients in whom iron deficiency anaemia is suspected, serum ferritin is a valid, precise diagnostic test.
Guyatt GH, Patterson CH, Ali M. Diagnosis of iron-deficiency anemia in the elderly. Am J Med 1990;88:205-9.
In a patient with anaemia can a low serum ferritin be used to diagnose iron deficiency?
"ferritin" and "sensitivity and specificity" in MEDLINE
- Gold Standard - bone marrow aspiration
- Study setting - consecutive pts over the age of 65 yr. who were admitted with anaemia to a university-affiliated hospital in Canada.
|Ferritin||Iron Deficiency||No Iron Deficiency||Likelihood Ratio|
|> 45 ≤ 100||7/85||27/150||0.44|
- Excluded pts from institutions and pts who were "too ill" or had "severe dementia" although these were not defined.
- Weighted kappa for bone marrow interpretation by 2 haematologists was 0.84.
- Low values can SpPin, and high values can SnNout.
- Also see the meta-analysis in J Gen Intern Med 1992;7:145-53. (with a correction on page 423).
S. Straus, 1996