The hidden burden of anemia in elderly surgical patients: a prospective study on incidence and contributing factors

Elderly surgical patients frequently experience anemia due to physiological changes, chronic comorbidities, and dietary deficiencies. Identifying associated risk factors is essential for improving surgical outcomes and reducing complications. To assess the incidence and determinants of anemia in elderly surgical patients at Debre Tabor Comprehensive Specialized Hospital in Ethiopia. A prospective observational study was conducted from June 1, 2024, to February 30, 2025, involving elderly patients undergoing surgery at Debre Tabor Comprehensive Specialized Hospital. Anemia was diagnosed based on World Health Organization (WHO) criteria, with hemoglobin levels assessed both preoperatively and postoperatively. Multivariable logistic regression was used to analyze patient demographics, comorbidities, and surgical factors to identify predictors of anemia. The incidence of anemia among elderly surgical patients was 64.8% (95% CI: 59.5-70.4%). Significant predictors included emergency surgery (AOR: 5.3, 95% CI: 3.2-8.3, p < 0.001), preexisting comorbidities (AOR: 2.5, 95% CI: 1.52-7.02, p < 0.001), blood loss > 500 mL (AOR: 9.8, 95% CI: 3.2-29.6, p < 0.001), polypharmacy (AOR: 4.8, 95% CI: 1.3-11.9, p < 0.001), major surgery (AOR: 3.9, 95% CI: 1.71-7.81, p < 0.001), and a history of previous surgeries (AOR: 7.7, 95% CI: 2.3-26.0, p < 0.001). The incidence of anemia in elderly surgical patients at Debre Tabor Comprehensive Specialized Hospital is high and associated with several modifiable risk factors. Early detection and targeted preoperative optimization strategies are crucial for improving surgical outcomes in this population.