Anaemia: Diagnosis of iron deficiency anemia in the elderly
Clinical Bottom Line
Acute Cholecystitis - Lap chole may be as safe as open chole
Citation
Guyatt GH, Patterson C, Ali M, Singer J, Levine M, Turpie I, Meyer R: Diagnosis of iron-deficiency anemia in the elderly. Am J Med 1990;88:205-9.
Clinical Question
In a patient with anaemia can a low serum ferritin be used to diagnose iron deficiency?
Search Terms
"ferritin" and "sensitivity and specificity" in MEDLINE
The Study
- 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.
The Evidence
| Ferritin | Iron Deficiency | No Iron Deficiency | Likelihood Ratio |
|---|---|---|---|
| ≤ 45 | 70/85 | 15/150 | 8.2 |
| >45 ≤ 100 | 7/85 | 27/150 | 0.44 |
| > 100 | 8/85 | 108/150 | 0.13 |
| Totals | 85 | 150 |
Comments
- Excluded patients from institutions and patients 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).
Appraised By
Straus, 1996, Reviewed 1998
Expiry Date
2000