Insufficient classification of anaemia in general practice: a Danish register-based observational study

Scandinavian Journal of Primary Health Care

Anette Tarp Hansen¹  Jon Emery²  Lene Sofie Granfeldt Østgård³  Kaj Sparle Christensen⁴  Alina Zalounina Falborg⁴  Astrid Boennelykke⁴  Henry Jensen⁴  Peter Vedsted⁴ 

[1] Department of Clinical Epidemiology, Aarhus University Hospital;Department of General Practice and Centre for Cancer Research, Victorian Comprehensive Cancer Centre, University of Melbourne;Department of Haematology, Odense University Hospital;Research Unit for General Practice;

关键词: general practice;    anaemia;    haemoglobins;    primary health care;    cross-sectional studies;    denmark;   

DOI  :  10.1080/02813432.2021.1958499

来源: DOAJ

【 摘 要 】

Background Anaemia can be a pointer of underlying severe disease, including undiagnosed malignancy. Subsequent blood tests are essential to classify the anaemia into subtypes and to facilitate targeted diagnostic investigation to ensure timely diagnosis of underlying disease. Objective We aimed to describe and classify anaemia based on laboratory tests from patients with new-onset anaemia detected in general practice. An additional aim was to analyse associations between patient characteristics and unclassified anaemia (not classifiable according to an algorithm). Design Population-based cross-sectional study. Setting Danish general practice. Subjects A total of 62,731 patients (age: 40–90 years) with new-onset anaemia were identified in Danish laboratory information systems and nationwide registries, and data were obtained for 2014–2018. Main outcome measures We measured the proportion of patients classified into subtypes of anaemia based on blood tests requested by general practitioners within 31 days of the anaemia index date. Results Of the 62,731 patients with new-onset anaemia, we identified unclassified anaemia in 78.9% (95% confidence interval (CI): 77.3–80.5) of men and 65.1% (CI: 63.4–66.9) of women. The likelihood of unclassified anaemia increased with age, increasing comorbidity and decreasing severity of anaemia. Conclusion The majority of patients with new-onset anaemia could not be classified through a simple algorithm due to missing blood tests, which highlights a potential missed opportunity for diagnosis. Standardised laboratory testing of patients with anaemia is warranted to ensure adequate follow-up and early detection of underlying severe disease.KEY POINTS Anaemia can be a sign of malignancy, and anaemia classification is an important step in the diagnosis of underlying disorders. The majority of patients with anaemia could not be classified according to a simple algorithm due to missing blood tests. Some patient characteristics were associated with a high risk of unclassified anaemia: high age, high comorbidity, and severe anaemia. Standardised laboratory testing in patients with anaemia is needed to inform targeted diagnostic investigation to ensure timely diagnosis.

【 授权许可】

Unknown