Mathurin Sebastián Alfonso, Agüero Andrés Pablo, Dascani Natalia Andrea, Prestera Jorgelina Ana, Gianserra Carina, Londero Eliana, Chiorra Carolina
Servicio de Clínica Médica, Hospital Intendente Carrasco, Rosario, Argentina.
Acta Gastroenterol Latinoam. 2009 Jun;39(2):103-11.
few studies have examined the anemia in hospitalized cirrhotic patients.
to assess the prevalence, predictive factors and prognosis for mortality of anemia in admitted cirrhotic patients.
descriptive study of cases and controls; 178 hospitalization of 114 patients were reviewed (mean age 52.4 years; 106 alcoholics) between May/2004 and June/2007. Those with acute losses of blood were excluded. The anemia was classified as slight, moderate, and severe, since a hemoglobin < 12 g/dl. There were considered as cases the admissions in which the hemoglobin had < 10 g/dl (moderate and severe anemia).
a diagnosis of anemia was made in 155 admissions, 47% were moderate and 19% severe. Hospital mortality rate in cases was 19.6%, and in controls 5.3%, [OR 4.39 (p = 0.004)]. The independent predictive factors for mortality were: score of Child-Pügh [OR 1.99 (p = 0.0005)], creatinine > 1.5 mg/dl [OR 11.34 (p = 0.0006)] and infections [OR 5.78 (p = 0.018)]. The cases had a greater risk of renal insufficiency [27.5% vs. 3.9%, OR 9.2 (p = 0.0001)]. Classification of Child-Pügh, total bilirubin > 10 mg/dl, albumin < 2.5 g/dl, infections, hepatic encephalopathy and alcoholic hepatitis also were predictive factors of moderate-severe anemia. The independent predictive factors for moderate-severe anemia were score ofChild-Piigh and renal insufficiency.
the anemia had a high prevalence with an increase of hospital mortality rate, although it was not an independent risk factor for death. The renal insufficiency and the severity of the hepatic disease were associated in independent form with moderate-severe anemia in patients admitted with cirrhosis.
很少有研究调查住院肝硬化患者的贫血情况。
评估入院肝硬化患者贫血的患病率、预测因素及死亡预后。
病例对照描述性研究;回顾了2004年5月至2007年6月期间114例患者的178次住院情况(平均年龄52.4岁;106例为酗酒者)。排除急性失血患者。贫血根据血红蛋白<12 g/dl分为轻度、中度和重度。血红蛋白<10 g/dl(中度和重度贫血)的入院患者被视为病例。
155例入院患者被诊断为贫血,其中47%为中度,19%为重度。病例组的医院死亡率为19.6%,对照组为5.3%,[比值比4.39(p = 0.004)]。死亡的独立预测因素为:Child-Pügh评分[比值比1.99(p = 0.0005)]、肌酐>1.5 mg/dl[比值比11.34(p = 0.0006)]和感染[比值比5.78(p = 0.018)]。病例组发生肾功能不全的风险更高[27.5%对3.9%,比值比9.2(p = 0.0001)]。Child-Pügh分级、总胆红素>10 mg/dl、白蛋白<2.5 g/dl、感染、肝性脑病和酒精性肝炎也是中度至重度贫血的预测因素。中度至重度贫血的独立预测因素为Child-Piigh评分和肾功能不全。
贫血患病率高,且医院死亡率增加,尽管它不是死亡的独立危险因素。肾功能不全和肝病严重程度与肝硬化入院患者的中度至重度贫血独立相关。