Relevance of pre-existing anaemia for patients admitted for acute coronary syndrome to an intensive care unit: a retrospective cohort analysis of 7418 patients

Abstract

Background Patients with acute coronary syndrome (ACS) frequently suffer from anemia, but its role in patients admitted to an Intensive Care Unit (ICU) is unclear. This analysis evaluates the prognostic relevance of different degrees of anemia and their specific impact on disease severity and the outcome in critically ill ACS patients. Methods The multi-center eICU Collaborative Research Database was used, and all patients admitted with ACS were included in a retrospective analysis. Anemia and its degrees were defined according to the criteria by the World Health Organization. A multi-level logistic regression analysis was used to fit three sequential regression models for the binary primary outcome of hospital mortality. Results A total of 7,418 patients were included; 3,437 patients (46%) had anemia on admission. Patients with anemia were significantly older (61 (53-70) versus 70 (61-78) years, p < 0.001), more often female (p < 0.001), and required an increased rate of vasopressor use (p < 0.001) and mechanical ventilation (p < 0.001). With the higher SOFA (1 vs. 2 p < 0.001) and APACHE (35 vs. 47; p < 0.001) scores, a higher degree of anemia was associated with prolonged ICU stay (2 vs. 5 days, p < 0.001). Even patients with mild anemia needed significantly from more intensive treatment and suffered worse outcome. ICU- and hospital mortality were inversely associated with hemoglobin levels. Conclusions Nearly half of critically ill patients with ACS suffer from anemia, which is associated with increased illness severity, complex ICU procedures, and mortality – even in mild anemia. Hemoglobin on admission is an independent factor for adverse outcome.

Frequency of Iron Deficiency Anemia in Ischemic Stroke

“…It was also reported in literature that anemia and iron deficiency can be risk factors to causeweakened muscles, early weariness, low quality of life, extended hospital stays, and decreased survival. A history of iron deficiency anemia was more common in patients with ischemic stroke than in those without ischemic stroke 9 . Lower blood iron content is indicative of decreased iron transport and negative iron balance and hence islinkedwith enhanced risk of stroke in the elderly patients.…”

“…The most prevalent blood illness, anemia, has been linked in a significant way to both cerebrovascular and cardiovascular conditions 9 . Only the sickle cell anemia subtype was shown to have a strong correlation with CVA.…”