Prevalence of anaemia, iron, and vitamin deficiencies in the Irish health system

Abstract

BackgroundAnaemia is a common but treatable condition that predicts adverse clinical outcomes.AimEstimate the prevalence of anaemia and extent of screening for common underlying causes in the Irish healthcare system.Design & settingWe conducted a retrospective cohort study of 112,181 adult patients, age ≥18 years who had a full blood count performed in 2013 using data from the National Kidney Disease Surveillance System.MethodThe prevalence of anaemia was determined across demographic and clinical subgroups according to World Health Organisation definitions. The proportion screened for iron, vitamin B12 and folate deficiency was determined within a 3-month follow-up period and the corresponding prevalence for each deficiency determined.ResultsThe overall prevalence of anaemia was 12.0% (95%CI 11.8–12.2) and was higher in women than men (13.2% vs 10.5%,P<0.001). Anaemia increased with advancing age (40.1% for those >80 years) and worsening kidney function (8.2%, 10.9%, 33.2% and 63.8% for each eGFR categories >90, 60–89, 30–59 and <30 mL/min/1.73 m² respectively,P<0.001). After 3-months follow-up, the proportion screened for iron deficiency was 11.2% based on transferrin saturation and 33.7% using serum ferritin. Screening for folate and B12 deficiency was 17.6% and 19.8% respectively. Among screened patients, the prevalence of iron deficiency, B12 and folate deficiency was 37%, 6.3%, and 5.8% respectively.ConclusionThe burden of anaemia in the healthcare system is substantial especially for elderly patients and those with advanced kidney disease. Low screening rates for iron, B12 and folate deficiency are common and warrant quality improvement initiatives.