The influence of anaemia on pressure ulcer healing in elderly patients
Anaemia is a common and multifactorial blood disorder in elderly individuals. This condition may be a significant barrier to pressure ulcers healing as it is associated with a decreased level of oxygen being supplied to body tissues. Some nutritional deficiencies such as iron, vitamin B12 and folate may also cause anaemia and have a negative impact on pressure ulcer healing. An increased iron demand in hard-to-heal pressure ulcers is a significant factor associated with the risk of anaemia of chronic disease in elderly patients. Anaemia screening and correction may need to be considered as well as iron supplementation if required in pressure ulcer prevention and management.
Anaemia is a common condition with prevalence of 20% and is greater in patients over 85 years of age (Goodnough and Schrier, 2014). It varies in elderly patients depending on various factors such as an individual's socioeconomic status (Styszynski et al, 2018), psychological state (Hosseini et al, 2018), dementia diagnosis (Andreev et al, 2020), and available support. This condition may affect almost one in two elderly individuals in nursing homes or those admitted to hospital (Gaskell et al, 2008) and also can be highly associated with elderly patients in palliative care as anaemia was found in 77% of men and 68% of women in a study by Dunn et al (2003). Anaemia in elderly patients is often multifactorial (Thomas, 2017) and usually mild (haemoglobin level 11-12.9 g/dl for men and 11-11.9 g/dl for women) (Gaskell et al, 2008); however, the most common cause of this condition is iron deficiency due to malnutrition, decreased iron absorption, chronic gastrointestinal blood loss or chronic inflammatory conditions (Andrès et al, 2008; Girelli et al, 2018; Cappellini et al, 2020).
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