Anemia is a Mortality Predictor in Hospitalized Patients for COPD Exacerbation

Martínez‐Rivera, Carlos; Portillo, Karina; Muñoz-Ferrer, Aida; Martínez-Ortiz, María Luisa; Molins, Elena; Serra, Pere; Ruiz-Manzano, Joan; Morera, Josep

doi:10.3109/15412555.2011.647131

Cited by 69 publications

(57 citation statements)

References 37 publications

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“…The prevalence of anemia in this study exceeds the prevalence found by Martinez-Rivera et al19 A possible explanation is the exclusion from that study of patients with certain comorbidities or severe acute disease, both of which are associated with low hemoglobin. In contrast, a higher prevalence than ours was found in Silverberg et al31 Possible explanations are a different case mix where, for example, diabetes was twice as frequent as in our population and the exclusion from our study of patients admitted previously for AECOPD.…”

Section: Discussioncontrasting

confidence: 79%

“…Though this association is known in stable-phase COPD patients,34 to our knowledge only one small study has examined the association between anemia and long-term mortality in patients admitted to hospital with AECOPD 19. The association found with hemoglobin <130 g/L in that population was very strong, with an odds ratio for death within a year after admission of 5.9.…”

Section: Discussionmentioning

confidence: 93%

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Association between hemoglobin and prognosis in patients admitted to hospital for COPD

Toft-Petersen¹,

Torp‐Pedersen²,

Weinreich³

et al. 2016

COPD

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Low concentrations of hemoglobin have previously been demonstrated in many patients with COPD. There is evidence of anemia as a prognostic factor in acute exacerbations, but the detailed relationship between concentrations of hemoglobin and mortality is not known. A register-based cohort of patients admitted for the first time to Danish hospitals for acute exacerbations of COPD from 2007 through 2012 was established. Age, sex, comorbidities, medication, renal function, and concentrations of hemoglobin were retrieved. Sex-specific survival analyses were fitted for different rounded concentrations of hemoglobin. The cohort encompassed 6,969 patients. Hemoglobin below 130 g/L was present in 39% of males and below 120 g/L in 24% of females. The in-hospital mortality rates for patients with hemoglobin below or above these limits were 11.6% and 5.4%, respectively. After discharge, compared to hemoglobin 130 g/L, the hazard ratio (HR) for males with hemoglobin 120 g/L was 1.45 (95% confidence interval [CI] 1.22–1.73), adjusted HR 1.37 (95% CI 1.15–1.64). Compared to hemoglobin 120 g/L, the HR for females with hemoglobin 110 g/L was 1.4 (95% CI 1.17–1.68), adjusted HR 1.28 (95% CI 1.06–1.53). In conclusion, low concentrations of hemoglobin are frequent in COPD patients with acute exacerbations, and predict long-term mortality.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 93%

Association between hemoglobin and prognosis in patients admitted to hospital for COPD

Toft-Petersen¹,

Torp‐Pedersen²,

Weinreich³

et al. 2016

COPD

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“…In a retrospective study of a series of patients with various disorders who were discharged from hospital, anaemia prevalence among COPD patients was 23.1 %, comparable with the one among individuals with heart failure [23]. In a longitudinal study by Almagro et al [14], anaemia prevalence among hospitalized patients for AE-COPD was 19.3 %, whereas other authors have reported even higher frequencies, ranging from 26 % to 33 % [15,28]. Hospitalacquired anaemia [29] is a unique entity affecting patients with various disorders who are admitted in hospital; nevertheless, during AECOPD, the burst of systemic inflammation is a factor further inhibiting erythropoiesis, as described below in detail.…”

mentioning

confidence: 72%

Anaemia in chronic obstructive pulmonary disease: an insight into its prevalence and pathophysiology

2014

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Chronic obstructive pulmonary disease (COPD) is a major health problem, with increasing morbidity and mortality. There is a growing literature regarding the extra-pulmonary manifestations of COPD, which can have a significant impact on symptom burden and disease progression. Anaemia is one of the more recently identified co-morbidities, with a prevalence that varies between 4.9% and 38% depending on patient characteristics and the diagnostic criteria used. Systemic inflammation seems to be an important factor for its establishment and repeated bursts of inflammatory mediators during COPD exacerbations could further inhibit erythropoiesis. However, renal impairment, malnutrition, low testosterone levels, growth hormone level abnormalities, oxygen supplementation, theophylline treatment, inhibition of angiotensin-converting enzyme and aging itself are additional factors that could be associated with the development of anaemia. The present review evaluates the published literature on the prevalence and significance of anaemia in COPD. Moreover, it attempts to elucidate the reasons for the high variability reported and investigates the complex pathophysiology underlying the development of anaemia in these patients.

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“…COPD combined with anemia was more common than polycythemia in our study. The incidence of anemia in COPD was between 10% and 15%, and anemia increases the severity of dyspnea, reduces exercise tolerance, and increases risk of death 32,33 . Barba et al studied 289,077 hospitalized AECOPD patients and found 9.8% of cases coexisted with anemia, and anemia increased the risk of readmission by 25% in the two-year study period 34 .…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with chronic obstructive pulmonary disease early readmission

Lin

Yang

et al. 2013

Current Medical Research and Opinion

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Anemia is a Mortality Predictor in Hospitalized Patients for COPD Exacerbation

Abstract: Anemia and previous exacerbations were independent predictors of mortality after one year in patients hospitalized for AECOPD.

Cited by 69 publications

References 37 publications

Association between hemoglobin and prognosis in patients admitted to hospital for COPD

Association between hemoglobin and prognosis in patients admitted to hospital for COPD

Anaemia in chronic obstructive pulmonary disease: an insight into its prevalence and pathophysiology

Risk factors associated with chronic obstructive pulmonary disease early readmission

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