Prognostic implications of Anemia in patients with acute heart failure in emergency departments. ANEM-AHF Study
Por:
Fernandez-Rodriguez, MD, Prieto-Garcia, B, Vazquez-Alvarez, J, Jacob, J, Gil, V, Miro, O, Llorens, P, Martin-Sanchez, FJ, Alquezar-Arbe, A, Rodriguez-Adrada, E, Romero-Pareja, R, Lopez-Diez, P, Herrero-Puente, P
Publicada:
1 abr 2021
Ahead of Print:
1 ene 2021
Resumen:
Introduction The presence of anaemia leads to a worse prognosis in patients with heart failure (HF). There are few data on the impact of anaemia on mortality in patients with acute heart failure (AHF), and the studies available are mainly retrospective, and include hospitalised patients.
Objective Evaluate the role of anaemia on 30-day and 1-year mortality in patients with AHF attended in hospital emergency departments (HEDs).
Methods We performed a multicentre, observational study of prospective cohorts of patients with AHF. The study variables were: Anaemia (haemoglobin < 12g/dL in women and <13g/dL in men), mortality at 30 days and at 1 year, risk factors, comorbidity, functional impairment, basal functional grade for dyspnoea, chronic and acute treatment, clinical and analytical data of the episode, and patient destination. Statistical analysis: Bivariate analysis and survival analyses using Cox regression.
Results A total of 13 454 patients were included, 7662 (56.9%) of whom had anaemia. Those with anaemia were older, had more comorbidity, a worse functional status and New York Heart Association class, greater renal function impairment, and more hyponatraemia. The mortality was higher in patients with anaemia at 30 days and 1 year: 7.5% vs 10.7% (P < .001) and 21.2% vs 31.4% (P < .001), respectively. The crude and adjusted hazard ratios of anaemia for 30-day mortality were: 1.46 (confidence interval [CI] 95% 1.30-1.64); P < .001 and 1.20 (CI 95% 1.05-1.38); P = .009, respectively, and 1.57 (CI 95% 1.47-1.68) and 1.30 (CI 95% 1.20-1.40) for mortality at 1 year. The weight of anaemia on mortality was different in each follow-up period.
Conclusions Anaemia is an independent predictor of mortality at 30 days and 1 year in patients with AHF attended in HEDs. It is important to study the aetiology of AHF since adequate treatment would reduce mortality.
Filiaciones:
Fernandez-Rodriguez, MD:
Hosp Univ Cent Asturias, Serv Hematol & Hemoterapia, Oviedo, Spain
Inst Invest Sanitaria Principado Asturias ISPA, Grp Invest Urgencias & Emergencias, Oviedo, Spain
Prieto-Garcia, B:
Inst Invest Sanitaria Principado Asturias ISPA, Grp Invest Urgencias & Emergencias, Oviedo, Spain
Hosp Univ Cent Asturias, Area Gest Clin Lab Med, Oviedo, Spain
Univ Oviedo, Oviedo, Spain
Vazquez-Alvarez, J:
Inst Invest Sanitaria Principado Asturias ISPA, Grp Invest Urgencias & Emergencias, Oviedo, Spain
Hosp Univ Cent Asturias, Unidad Gest Clin Urgencias, Avda Roma S-N, Oviedo 33011, Spain
Jacob, J:
Hosp Univ Bellvitge, Serv Urgencias & Unidad Corta Estancia, Barcelona, Spain
Gil, V:
Hosp Clin Barcelona, Area Urgencias, Grp Invest Urgencias Proc & Patol, IDIBAPS, Barcelona, Spain
Miro, O:
Hosp Clin Barcelona, Area Urgencias, Grp Invest Urgencias Proc & Patol, IDIBAPS, Barcelona, Spain
Llorens, P:
Hosp Gen Univ Alicante, Serv Urgencias Corta Estancia & Hospitalizac Domi, Alicante, Spain
Martin-Sanchez, FJ:
Univ Complutense Madrid, Hosp Clin San Carlos, Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Ctr Nacl Invest Cardiovasculares CNIC,Serv Urgenc, Madrid, Spain
Alquezar-Arbe, A:
Hosp Santa Creu & Sant Pau, Serv Urgencias, Barcelona, Spain
Rodriguez-Adrada, E:
Hosp Rey Juan Carlos Mostoles, Serv Urgencias, Madrid, Spain
Romero-Pareja, R:
Hosp Univ Getafe, Serv Urgencias, Madrid, Spain
Lopez-Diez, P:
Hosp Univ Burgos, Serv Urgencias, Burgos, Spain
Herrero-Puente, P:
Inst Invest Sanitaria Principado Asturias ISPA, Grp Invest Urgencias & Emergencias, Oviedo, Spain
Univ Oviedo, Oviedo, Spain
Hosp Univ Cent Asturias, Unidad Gest Clin Urgencias, Avda Roma S-N, Oviedo 33011, Spain
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