Anémie et transfusion chez le patient âgé en médecine d'urgence Anemia and transfusion in elderly in emergency conditions

Anemia is the most frequent hematological problem in elderly with a 10 to 50% prevalence. There are few specific studies on transfusion in elderly people and the recommendations published by Afssaps are inadequate on this polypathological population. For acute anemia, thresholds adopted by Afssaps are: 7 g/dl for patients without medical history, 8 to 9 g/dl for patients with cardiovascular history, and 10 g/dl for patients with bad tolerance to lower concentration or with acute coronary or cardiac insufficiency. For chronic anemia, the indication is based on correction of symptoms related to anemia, and a threshold of 8 g/dl is adopted for patients with cardiovascular history or over 65 year-old. More than the hemoglobin level, the principal criteria for transfusion would be the tolerance to anemia. It depends on the hemoglobin level, the rapidity of L. Zerah (*) · J. Boddaert (*) Service de geriatrie, hopital de la Pitie-Salpetriere, Assistance publique–Hopitaux de Paris, universite Paris-VI, 47, boulevard de l’Hopital, F-75013 Paris, France e-mail : Lorenez@free.fr, Jacques.boddaert@psl.aphp.fr Cah. Annee Gerontol. (2011) 3:90-97 DOI 10.1007/s12612-011-0185-2