Department of Cardiology, Affiliated Hospital of Qinghai University, Xining, China.
Department of Surgical Oncology, Affiliated Hospital of Qinghai University, Xining, China.
Am J Med Sci. 2019 Sep;358(3):191-199. doi: 10.1016/j.amjms.2019.05.016. Epub 2019 Jun 8.
Anemia may be an independent risk factor of death. Therefore, the current meta-analysis aimed to explore the relationship of anemia with all-cause mortality (ACM) and cardiovascular mortality (CVM) to provide evidence-based medical facts.
Three major electronic databases, the National Library of Medicine of the USA (PubMed), Cochrane Library and Embase, were searched from inception to October 2018. Relevant studies were screened in strict accordance with the inclusion and exclusion criteria, and the pooled hazard ratios (HRs) together with the 95% confidence intervals (CIs) were performed to assess the statistically significant difference of anemia compared with ACM and CVM.
A total of 15 related studies were included. Our results suggested that among the mixed population regardless of sex, age and cardiovascular diseases (CVD), the ACM and CVM of anemia patients were increased, with the HRs and 95% CIs of 1.41 (1.33, 1.50) and 1.33 (1.23, 1.45), respectively. Meanwhile, the ACM of anemia patients with the mean age of over 65 or below 65 years was increased irrespective of sex and CVD, with the HRs and 95% CIs of 1.43 (1.26, 1.61) and 1.41 (1.32, 1.50), separately. Moreover, the risks of ACM were increased in male, female and mixed sex anemia patients despite age and CVD, with the HRs and 95% CIs of 1.39 (1.29, 1.49), 1.25 (1.20, 1.30) and 1.53 (1.39, 1.68), respectively. All patients with CVD and no CVD were associated with an increased risk of ACM regardless of age and sex, with the HRs and 95% CIs of 1.42 (1.33, 1.51) and 1.38 (1.16, 1.63), respectively.
Anemia is a risk factor to predict ACM and CVM among the general population, which is independent of sex, age, and history of CVD.
贫血可能是死亡的独立危险因素。因此，本项荟萃分析旨在探讨贫血与全因死亡率（ACM）和心血管死亡率（CVM）的关系，为循证医学提供事实依据。
从美国国立医学图书馆（PubMed）、Cochrane 图书馆和 Embase 三个主要的电子数据库中检索，检索时间截至 2018 年 10 月。严格按照纳入和排除标准筛选相关研究，采用合并风险比（HR）及其 95%置信区间（CI）评估贫血与 ACM 和 CVM 的统计学差异。
共纳入 15 项相关研究。结果表明，在不论性别、年龄和心血管疾病（CVD）的混合人群中，贫血患者的 ACM 和 CVM 增加，HR 值及其 95%CI 分别为 1.41（1.33，1.50）和 1.33（1.23，1.45）。同时，不论性别和 CVD，年龄超过 65 岁或低于 65 岁的贫血患者的 ACM 也增加，HR 值及其 95%CI 分别为 1.43（1.26，1.61）和 1.41（1.32，1.50）。此外，不论年龄和 CVD，男性、女性和混合性贫血患者的 ACM 风险均增加，HR 值及其 95%CI 分别为 1.39（1.29，1.49）、1.25（1.20，1.30）和 1.53（1.39，1.68）。不论年龄和性别，所有 CVD 患者和无 CVD 患者的 ACM 风险均增加，HR 值及其 95%CI 分别为 1.42（1.33，1.51）和 1.38（1.16，1.63）。
贫血是预测一般人群 ACM 和 CVM 的危险因素，与性别、年龄和 CVD 病史无关。
