Ugarph-Morawski Anna, Wändell Per, Benson Lina, Savarese Gianluigi, Lund Lars H, Dahlström Ulf, Eriksson Björn, Edner Magnus
Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Academic Primary Care Center, Region Stockholm, Stockholm, Sweden.
Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Arch Gerontol Geriatr. 2025 Feb;129:105645. doi: 10.1016/j.archger.2024.105645. Epub 2024 Sep 26.
Many patients with heart failure (HF) are managed in primary care, and comorbidities are common. Anemia is one frequent comorbidity. The aim of this study was to assess the prevalence, comorbidities, and prognosis of HF patients in primary care who have anemia.
We linked data on 9300 patients managed in primary care from the nationwide SwedeHF registry with other Swedish national register data. A multivariable logistic regression model with anemia as a dependent variable was performed. Multivariate Cox proportional hazards regression analysis was used to model the time to event.
The median age (IQR) was 81 (74-86) years, and 45 % of the patients were female. A total of 2852 (30.7 %) had anemia. Anemia was more common in men, in those ≥75 years, and in those with kidney dysfunction. A total of 695 (10.8 %) of patients without and 520 (18.2 %) with anemia had cancer. Cancer was independently associated with anemia (OR 1.5, 95 % CI 1.3-1.7). Other comorbidities significantly associated with anemia were peripheral artery disease (OR 1.39, 95 % CI 1.18-1.65), diabetes (OR 1.29, 95 % CI 1.16-1.44), and liver disease (OR 1.64, 95 % CI 1.09-2.46). If anemia was present, prognosis was worse. Risk of all-cause hospitalization was higher (adjusted HR 1.3, 95 % CI 1.2-1.4), as was risk of all-cause mortality (adjusted HR 1.4, 95 % CI 1.3-1.5).
Anemia is common in primary care patients with HF. It is associated with worse prognosis and comorbidities, most notably cancer.
许多心力衰竭（HF）患者在基层医疗中接受管理，且合并症很常见。贫血是一种常见的合并症。本研究的目的是评估基层医疗中合并贫血的HF患者的患病率、合并症及预后情况。
我们将来自全国性瑞典心力衰竭登记处的9300例在基层医疗中接受管理的患者数据与其他瑞典国家登记数据相链接。构建了以贫血为因变量的多变量逻辑回归模型。采用多变量Cox比例风险回归分析对事件发生时间进行建模。
中位年龄（四分位间距）为81（74 - 86）岁，45%的患者为女性。共有2852例（30.7%）患者患有贫血。贫血在男性、75岁及以上人群以及肾功能不全者中更为常见。无贫血的患者中有695例（10.8%）患癌症，有贫血的患者中有520例（18.2%）患癌症。癌症与贫血独立相关（比值比1.5，95%置信区间1.3 - 1.7）。与贫血显著相关的其他合并症包括外周动脉疾病（比值比1.39，95%置信区间1.18 - 1.65）、糖尿病（比值比1.29，95%置信区间1.16 - 1.44）和肝病（比值比1.64，95%置信区间1.09 - 2.46）。若存在贫血，预后更差。全因住院风险更高（校正风险比1.3，95%置信区间1.2 - 1.4），全因死亡风险也更高（校正风险比1.4，95%置信区间1.3 - 1.5）。
贫血在基层医疗的HF患者中很常见。它与更差的预后和合并症相关，最显著的是癌症。
