Scuola di Specializzazione in Medicina Interna, Università degli Studi di Milano, Milan, Italy.
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Intern Emerg Med. 2017 Sep;12(6):749-756. doi: 10.1007/s11739-017-1637-5. Epub 2017 Feb 23.
Anemia is a risk factor related to morbidity and mortality in patients with chronic heart failure (HF). Less is known about its influence in patients in an early stage of HF. Our aim is to investigate the prognostic role of anemia in patients initially hospitalized for acute HF. We reviewed all consecutive patients admitted within a 18-month period with a main diagnosis of acute HF. We collected demographic, clinical and treatment data. Anemia is defined as Hemoglobin <12/13 g/dL upon admission in female/male patients, respectively. 719 patients were included (55.5% female), with a mean age of 78.7 ± 9 years. Anemia was present in 59.6% of patients upon admission, with a mean Hb of 10.4 ± 1.4 g/dL. Multivariate analysis confirms the relationship between the presence of anemia and older age, a previous diagnostic history of diabetes, and the presence of chronic kidney disease. In-hospital mortality is similar for anemic and non-anemic patients (6.8 vs 3.8%, p = n.s.) However, the difference is significant when one-year mortality is evaluated (31% in anemic patients vs 19% in non-anemic patients, p < 0.001). Cox regression analysis confirms the association between anemia and higher risk of one-year mortality, as well as with older age and a higher Charlson comorbidity index. Our study confirms that the presence of anemia is an independent factor for mid-term (1-year) mortality even in patients experiencing a first admission due to acute HF.
贫血是慢性心力衰竭（HF）患者发病率和死亡率的相关风险因素。但对于 HF 早期患者，贫血对其影响的相关信息较少。我们旨在研究贫血对急性 HF 初次住院患者的预后作用。我们回顾了在 18 个月内以急性 HF 为主要诊断的所有连续入院患者。我们收集了人口统计学、临床和治疗数据。贫血定义为女性患者入院时血红蛋白<12/13g/dL，男性患者为血红蛋白<12/13g/dL。共纳入 719 例患者（55.5%为女性），平均年龄为 78.7±9 岁。入院时贫血患者占 59.6%，平均血红蛋白为 10.4±1.4g/dL。多变量分析证实贫血与年龄较大、既往诊断为糖尿病和慢性肾脏病有关。贫血患者与非贫血患者的院内死亡率相似（6.8%比 3.8%，p=无统计学意义）。但在评估 1 年死亡率时，差异有统计学意义（贫血患者为 31%，非贫血患者为 19%，p<0.001）。Cox 回归分析证实贫血与 1 年死亡率较高以及年龄较大和较高的 Charlson 合并症指数相关。本研究证实，即使在因急性 HF 初次入院的患者中，贫血也是中期（1 年）死亡率的独立因素。
