Anemia as a Predictor of Mortality in Patients with Decompensated Heart Failure

Abstract

Objective: To correlate the presence of anemia with mortality in hospitalized patients with decompensated HF (heart failure). Methods: A total of 148 patients hospitalized for HF compensation were analyzed from April 1 to December 31, 2017 in a tertiary referral hospital for cardiovascular diseases. The diagnosis of anemia was established according to the Brazilian Ministry of Health criteria, considering a serum hemoglobin value of < 13 g/dL for men and < 12 g/dL for women. Data were collected through medical and physical attendance records. Statistical analysis was performed using the Epi Info program, version 7.0 for Windows, with Student's t test for unpaired variables, Chi-square test and Fischer test. The significance of p < 0.05 was considered. Results: Of the 148 selected patients, 63.5% were male, 60.1% were over 65 years old, 50.74% were enrolled in the first grade, and 93.2% were self-declared white. The prevalence of anemia observed in the study population was 72 (56.25%), of which 49 (68%) were male and 23 (32%) were female. The mortality rate of the anemic patients was 19.4%, a total of 14 patients, whereas the non-anemic patients rate was 7.9%. It was observed that patients with worse outcome had hemoglobin < 12mg/dL (p = 0.045) and Functional Class (FC IV) by the New York Heart Association (NYHA) (p = 0.0001) at hospital admission. Conclusions: It is noticed that anemia is a frequent finding in patients with HF and that it interferes in the clinical manifestations, with worsening of the prognosis. Anemia treatment is not yet standarized in the HF approach, but patients without anemia appear to evolve with more favorable outcomes than anemia.

Structural Model of Biomedical and Contextual Factors Predicting In-Hospital Mortality due to Heart Failure

“…Anemia is present in more than half of HF patients, especially if there is renal insufficiency, and this is in relation to the degree of both kidney and HF. The role of anemia in the literature is variable; it appears as an intermediate variable not systematically associated with a long-term prognosis in the evidence reported by other authors [ 23 , 24 , 25 , 26 , 27 ], although certain population registries have associated low levels of hemoglobin with a poorer long-term prognosis [ 25 ]. Our results support anemia as more of a marker associated with gender, renal insufficiency and probably poorer clinical conditions than as a variable directly associated with mortality, in agreement with what other authors have suggested [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ].…”