Association between admission anemia and long-term mortality in patients with acute myocardial infarction: results from the MONICA/KORA myocardial infarction registry

Colombo, Miriam Giovanna; Kirchberger, Inge; Amann, Ute; Heier, Margit; Thilo, Christian; Kuch, Bernhard; Peters, Annette; Meisinger, Christa

doi:10.1186/s12872-018-0785-5

Cited by 30 publications

(20 citation statements)

References 33 publications

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“…In addition, patients with anemia are more likely to have worse outcomes and higher mortality when these complications occur. 6 , 26 The increase in risk of postoperative acute myocardial infarction and cardiac arrest has been noted in other studies. A study by Oldeji et al 20 found a similar relationship between presurgery anemia and the risk of myocardial infarction after TSA with an OR of 1.62.…”

Section: Discussionmentioning

confidence: 56%

Increasing severity of anemia is associated with poorer 30-day outcomes for total shoulder arthroplasty

et al. 2021

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Background Total shoulder arthroplasty (TSA) has increased in utilization over the past several decades. Anemia is a common preoperative condition among patients undergoing TSA and has been associated with poorer outcomes in other surgical procedures. To the best of our knowledge, no study has analyzed the association between anemia severity and TSA outcomes. Therefore, the purpose of this study is to determine the effects that increasing severity of anemia may have on the postoperative outcomes in patients receiving primary TSA. Methods A retrospective analysis was performed using the American College of Surgeons National Surgery Quality Improvement Project database from the years 2015 to 2018. Current Procedure Terminology code 23472 was used to identify all primary TSA procedures recorded during this time frame. Patients with greater than 38% preoperative hematocrit (HCT) were classified as having normal HCT levels. Patients with HCT values between 33% and 38% were classified as having mild anemia. All patients with less than 33% HCT were classified as having moderate/severe anemia. Patient demographic information, preoperative risk factors, and postoperative outcomes were compared among the 3 cohorts. A multivariate logistic regression including demographic factors and comorbidities was performed to determine whether increasing severity of anemia is independently associated with poorer postoperative outcomes. Results Of the 15,185 patients included in this study, 11,404 had normal HCT levels, 2962 patients were mildly anemic, and 819 patients had moderate to severe anemia. With increasing severity of anemia, there was an increased average hospital length of stay (1.6 vs. 2.1 vs. 3.0 days, P < .001), rate of readmissions (2.3% vs. 4.8% vs. 7.0%, P < .001), and rate of all reoperations (1.1% vs. 1.8% vs. 3.1%, P < .001). There was a statistically significant increase in both minor (1.9% vs. 2.7% vs. 4.4%, P < .001) and major (1.2% vs. 2.4% vs. 4.3%, P < .001) postoperative complication rates as well. Multivariate analysis identified anemia as an independent predictor of readmissions, reoperations, minor complications, and major complications. Conclusion We found increasing severity of anemia to be associated with progressively worse 30-day postoperative outcomes. This is consistent with the outcomes found for increasing severity of anemia in patients receiving other total joint procedures. Using preoperative HCT levels may be a useful tool for predicting the risk of postoperative complications in patients undergoing TSA. This information could be used to further optimize patient selection for primary TSA.

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Section: Discussionmentioning

confidence: 56%

Increasing severity of anemia is associated with poorer 30-day outcomes for total shoulder arthroplasty

et al. 2021

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“…Consistent with that finding, previous studies showed that the presence and severity of anemia was adversely associated with shortand long-term mortality risk. [13][14][15] Compared with the gen-…”

Section: Risk Factorsmentioning

confidence: 99%

A Practical Risk Score to Predict 24-Month Post-Discharge Mortality Risk in Patients With Non-ST-Segment Elevation Myocardial Infarction

Fu¹,

Song²,

Yang³

et al. 2020

Circ J

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in the context of acute coronary syndrome (ACS), including TIMI score, 4 GRACE score, 5 ACTION score, 6 Canada Acute Coronary Syndrome risk score, 7 and TRS-2P score. 8 These scores focus on risk prediction in the acute phase of AMI (i.e., the risk of death within the first year after discharge). However, patients who survive AMI still have a high risk of adverse cardiovascular events beyond the first year. 9 The objective of our study was to develop and validate a risk score to predict long-term risk in patients who survive NSTEMI. Methods CAMI RegistryA detailed description of the CAMI registry was reported T he number of patients surviving acute myocardial infarction (AMI) has increased in recent years 1 due to advances in early diagnosis and improved treatment. 2 However, survivors of AMI have varying risk of recurrent cardiovascular events. 2 AMI is most commonly classified as ST-elevation MI (STEMI) or non-STEMI (NSTEMI) based on ECG characteristics. Compared with patients with STEMI, those with NSTEMI display worse long-term clinical outcomes. 3 Accurate risk stratification, particular among patients with NSTEMI, may assist in identifying those at high risk of future adverse cardiac events and who may benefit from intensive secondary prevention to improve outcomes.Several scores have been developed to predict prognosis

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“…Anemia following acute myocardial infarction (AMI) is associated with poorer outcomes relative to nonanemic AMI patients. Furthermore, anemia is more frequently encountered in patients hospitalized for cardiac events than in the general population [1,2], ranging from 11% to 38% in patients with AMI [3,4].…”

Section: Introductionmentioning

confidence: 99%

Discharge Hemoglobin Association with Long-Term Outcomes of ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Gao

Zhang

Qin

et al. 2020

Cardiovascular Therapeutics

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Background. Anemia following acute myocardial infarction (AMI) is associated with poor outcomes. While previous studies in patients with AMI have focused on anemia at admission, we hypothesized that hemoglobin (Hb) decline during hospitalization and lower discharge Hb would be associated with greater long-term mortality in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Methods. We analyzed records of 983 STEMI patients who were treated with primary PCI. e primary end point was all-cause mortality at 1 year and 2 years. e relationship between discharge Hb levels, decline in Hb levels, bleeding event classification, and all-cause mortality was determined. Results. Overall, 16.4% of patients had bleeding events, which were classified by the rombolysis in Myocardial Infarction (TIMI) score as 7% minimal, 8.6% minor, and 0.9% major. No significant gastrointestinal bleed and cerebral hemorrhage occurred in hospitals among these patients. e incidence rate of the 2-year all-cause mortality increased with severity of the bleeding event score (8.78% for no bleeding vs. 11.59% for minimal bleeding vs. 20.24% for minor bleeding vs. 55.56% for major bleeding, P < 0.001). Discharge Hb was significantly associated with 2-year mortality in an unadjusted model (hazard ratio (HR) per 1 g/L decrease in discharge Hb � 1.020, 95% confidence interval (CI): 1.006-1.034, P � 0.004) and in a confounder-adjusted model (HR per 1 g/L decrease in discharge Hb � 1.024, 95% CI: 1.011-1.037, P < 0.001). e odds ratio (OR) for all-cause mortality at 2 years for participants with Hb below the twentieth percentile was 3.529 (95% CI: 1.976-6.302) and 2.968 (95% CI: 1.614-5.456) after adjustment for age and gender and 2.485 (95% CI: 1.310-4.715) after adjustment for all covariates. Conclusions. In this population of patients hospitalized for STEMI, all-cause mortality increased with lower discharge Hb, and discharge Hb was a significant predictor of mortality risk.

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Association between admission anemia and long-term mortality in patients with acute myocardial infarction: results from the MONICA/KORA myocardial infarction registry

Cited by 30 publications

References 33 publications

Increasing severity of anemia is associated with poorer 30-day outcomes for total shoulder arthroplasty

Increasing severity of anemia is associated with poorer 30-day outcomes for total shoulder arthroplasty

A Practical Risk Score to Predict 24-Month Post-Discharge Mortality Risk in Patients With Non-ST-Segment Elevation Myocardial Infarction

Discharge Hemoglobin Association with Long-Term Outcomes of ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

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