Anemia in COPD: A Systematic Review of the Prevalence, Quality of Life, and Mortality

Abstract

Anemia is common in patients with chronic diseases. However, little is known regarding the prevalence of comorbid anemia and its impact on quality of life, healthcare utilization, and mortality in patients with COPD. We conducted a systematic review and synthesis of the literature (1966 to March 2010). The prevalence of comorbid anemia in patients with COPD ranges from 7.5% to 34%, depending upon the populations selected and diagnostic tools employed to determine the level of hemoglobin. Comorbid anemia in patients with COPD was associated with greater healthcare resource utilization, impaired quality of life, older age, and male gender. Moreover, anemia in patients with COPD is an independent prognostic predictor of premature mortality and a greater likelihood of hospitalization. The true prevalence of anemia in patients with COPD is unknown. There is a lack of consensus agreement regarding this hematological abnormality's true frequency. Based on the findings from the existing literature, more work is necessary to establish the true prevalence of anemia in COPD. Robust and prospective clinical studies are needed to improve the management of COPD patients with comorbid anemia.

Osteoporosis in Chronic Obstructive Pulmonary Disease

“…Anemia is a common entity in COPD patients, and its prevalence varies from 7.5% to 34%, depending upon the selected populations and the diagnostic tools to determine the hemoglobin level 136. Several studies reported a connection between anemia and BMD.…”

Anaemia secondary to erythropoietin resistance: important predictor of adverse outcomes in chronic obstructive pulmonary disease

“…A systematic review of the literature (1966–2010) estimates this prevalence to range from 7.5% to 34%, depending on the population selected and the diagnostic tools used 4. Further, lower haemoglobin levels were found to be independently associated with increased functional dyspnoea, reduced exercise capacity, impaired quality of life, premature mortality and greater likelihood of hospitalisations and healthcare resource utilisations 4. Raising haemoglobin through transfusion decreases minute ventilation and work of breathing in patients with COPD, with unloading of respiratory muscles, thereby improving the functional limitation 5…”

“…The causes of anaemia in COPD are probably multifactorial, such as nutritional disorders, occult blood loss, drug induced (theophylline, ACE inhibitors), carboxyhaemoglobin effect of cigarette smoking, and even oxygen therapy 4. A particular important cause in these patients may relate to anaemia of chronic disease.…”

Effect on Outcomes and Exercise Performance of Anemia in Patients With Aortic Stenosis Who Underwent Transcatheter Aortic Valve Replacement

“…Anemia has been associated with a higher mortality in elderly subjects, 21 in patients with heart failure, 22 and in those with aortic stenosis who underwent SAVR and TAVR. 3,4,15 Also, anemia has been associated with poorer functional outcomes in elderly subjects 21 and in patients with heart failure, 22 chronic kidney disease, 23 or COPD, 24 comorbidities that are, indeed, present in a high proportion of TAVR candidates. Accordingly, the presence of even mild anemia in this study was an independent predictor of poorer exercise capacity as evaluated by the 6MWT, of lower DASI and KCCQ scores, and of a trend toward a worse NYHA class in patients with severe aortic stenosis considered for TAVR.…”