Brems Daniel Alexander, Petersen Jeppe Kofoed, Begun Xenia, Smerup Morten, Butt Jawad Haider, Køber Lars, Fosbøl Emil
Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark.
Eur Heart J Qual Care Clin Outcomes. 2025 Aug 11;11(5):529-538. doi: 10.1093/ehjqcco/qcae057.
Patients undergoing aortic valve replacement (AVR) have high readmission rates. Several risk factors have been proposed as potential modifiable targets, including anaemia. We examined the association between anaemia at discharge and subsequent outcomes in these patients.
Using Danish nationwide registries, we identified all patients who underwent AVR between 2015 and 2021, were alive at discharge (index date), and had an available haemoglobin (Hb) measurement taken between the procedure and discharge. Patients were categorized as having (i) moderate/severe anaemia (Hb <6.2 mmol/L) or (ii) no/mild anaemia (Hb ≥6.2 mmol). The 1-year rates of all-cause mortality, all-cause hospital admission, heart failure (HF) admission, and atrial fibrillation (AF) admission were compared using multivariable Cox regression models. A total of 8614 patients were identified; 2847 (33.1%) had moderate/severe anaemia (60.2% male, median age 74) and 5767 (66.9%) had no/mild anaemia (68.0% male, median age 76). For these two groups, respectively, the cumulative 1-year incidences of the outcomes were: (i) all-cause mortality: 5.1% vs. 4.3%; (ii) all-cause admission: 53.8% vs. 47.5%; (iii) AF admission: 14.0% vs. 11.6%; and (iv) HF admission: 6.8% vs. 6.2%. In adjusted analysis, moderate/severe anaemia, compared with no/mild anaemia, was associated with higher rates of all-cause mortality (hazard ratio (HR) 1.27 [95% confidence interval CI 1.02-1.58]), all-cause admission (HR 1.22 [95% CI 1.14-1.30]), and AF admission (HR 1.23 [95% CI 1.08-1.40]), but not HF admission (HR 1.09 [95% CI 0.91-1.31]).
In patients undergoing AVR, moderate/severe anaemia at discharge, compared with no/mild anaemia, was associated with increased all-cause mortality, all-cause hospital admission, and AF admission, but not HF admission, at 1-year post-discharge.
接受主动脉瓣置换术（AVR）的患者再入院率很高。已提出若干风险因素作为潜在的可改变目标，包括贫血。我们研究了这些患者出院时贫血与随后结局之间的关联。
利用丹麦全国性登记系统，我们确定了2015年至2021年间接受AVR、出院时存活（索引日期）且在手术与出院之间有可用血红蛋白（Hb）测量值的所有患者。患者被分类为患有（i）中度/重度贫血（Hb<6.2 mmol/L）或（ii）无/轻度贫血（Hb≥6.2 mmol）。使用多变量Cox回归模型比较全因死亡率、全因住院、心力衰竭（HF）住院和心房颤动（AF）住院的1年发生率。共确定了8614例患者；2847例（33.1%）患有中度/重度贫血（男性占60.2%，中位年龄74岁），5767例（66.9%）无/轻度贫血（男性占68.0%，中位年龄76岁）。对于这两组患者，各结局的累积1年发生率分别为：（i）全因死亡率：5.1%对4.3%；（ii）全因住院：53.8%对47.5%；（iii）AF住院：14.0%对11.6%；（iv）HF住院：6.8%对6.2%。在多因素分析中，与无/轻度贫血相比，中度/重度贫血与全因死亡率（风险比（HR）1.27[95%置信区间CI 1.02 - 1.58]）、全因住院（HR 1.22[95%CI 1.14 - 1.30]）和AF住院（HR 1.23[95%CI 1.08 - 1.40]）的发生率较高相关，但与HF住院无关（HR 1.09[95%CI 0.91 - 1.31]）。
在接受AVR的患者中，出院时中度/重度贫血与无/轻度贫血相比，在出院后1年时与全因死亡率增加、全因住院和AF住院相关，但与HF住院无关。
