Necessità di ridefinire i valori di normalità per globuli rossi e emoglobina nella popolazione anziana, come risultato di analisi di Big Data

AUTORI

ABSTRACT

The reference values for red blood cells and hemoglobin in the elderly population need to be reassessed as a result of Big Data analysis

Introduction: in elderly subjects, a reduction in hemoglobin levels is common, but whether this should be considered an overt manifestation of anemia or a para-physiological change associated with aging is controversial. The aim of this study was to investigate the association between alterations of the complete bold count (CBC) parameters and aging, in a large outpatient population in the province of Modena. Methods: CBC results from outpatients, performed in the clinical laboratory of the Ospedale Civile di Modena (Italy), from January 2010 to August 2022 have been examined. The data were retrieved from the Vertical Sequel Server where outpatients’ results are stored; statistical analyses were performed with the Anaconda 3, Python 3.7 platform. Results: CBC data collected were 4 673 529. Hemoglobin levels in elderly people (>75 years old), both males and females, were largely below the lower reference limit (respectively, 49.3% of 509 834 tests in the male population and 35.4% of 704 343 test in the female population). Evaluating a single value per person per year, the trend was similar: 40.5% of men and 27.5% of women. Finally, to exclude patients with organ disease, we limited our observation to subjects with normal values of serum glucose, creatinine and alanine transferase (ALT). In this series of 822 166 analyses, more than 25% of the older males show hemoglobin levels below the lower reference limit.
Discussion: in conclusion, a significant proportion of older male subjects in this outpatient population show hemoglobin levels below the reference limit. Exclusion from the statistical analysis of patients with altered liver and kidney tests and hyperglycemia (to exclude significant systemic or organ disease) did not change the finding. These results suggest extreme caution in the interpretation of the CBC in advanced age and may support a redefinition of the reference limits in this specific population.

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