School of Population Health, University of Western Australia, Perth, Western Australia, Australia.
Heart Lung Circ. 2010 Jan;19(1):31-7. doi: 10.1016/j.hlc.2009.08.004. Epub 2009 Sep 26.
To evaluate the association of anaemia with increased long-term morbidity and mortality in hospitalised heart failure (HF) patients.
We analysed medical records of a random sample of 1000 patients admitted to tertiary care hospitals from 1996 to 2006 with a principal diagnosis of HF. Anaemia (WHO criteria) on admission was present in 45.2% of HF patients. Multivariate analysis identified anaemia as an independent predictor of 5-year mortality with a hazard ratio (HR) of 1.44 (95%CI 1.20-1.73) compared to non-anaemic patients, and a rate ratio of 1.85 (95%CI 1.72-2.02) for unplanned all-cause readmission and 1.22 (95%CI 1.16-1.29) for HF readmission within 5 years. Compared to patients in the highest gender-specific Hb quartile, those with mild anaemia (Hb 11.3-13.0 g/dL in males, 11.0-12.4 g/dL in females) had an adjusted HR of 1.32 (95%CI 1.01-1.71) for 5-year mortality. Anaemia and chronic kidney disease were independent (additive) predictors of survival, whereas anaemia interacted with prevalent diabetes (p for interaction=0.006), such that patients with both conditions had an adjusted mortality HR of 2.18 (95%CI 1.48-3.22) compared to those with diabetes only.
Mild anaemia is common in hospitalised HF patients and is an independent predictor of 5-year all-cause mortality in HF.
评估贫血与住院心力衰竭（HF）患者长期发病率和死亡率增加的关系。
我们分析了 1996 年至 2006 年期间在三级保健医院住院的 1000 例以 HF 为主要诊断的患者的随机样本的病历。入院时存在贫血（WHO 标准）的 HF 患者占 45.2%。多变量分析确定贫血是 5 年死亡率的独立预测因素，与非贫血患者相比，风险比（HR）为 1.44（95%CI 1.20-1.73），计划外全因再入院的比率比为 1.85（95%CI 1.72-2.02），5 年内 HF 再入院的比率比为 1.22（95%CI 1.16-1.29）。与最高性别特定 Hb 四分位患者相比，轻度贫血（男性 Hb 11.3-13.0 g/dL，女性 Hb 11.0-12.4 g/dL）患者的 5 年死亡率调整 HR 为 1.32（95%CI 1.01-1.71）。贫血和慢性肾脏病是生存的独立（附加）预测因素，而贫血与常见糖尿病存在相互作用（p 交互=0.006），因此，与仅患有糖尿病的患者相比，患有这两种疾病的患者的调整死亡率 HR 为 2.18（95%CI 1.48-3.22）。
轻度贫血在住院 HF 患者中很常见，是 HF 患者 5 年全因死亡率的独立预测因素。
