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de Los Ángeles Fernández-Rodríguez M, Prieto-García B, Vázquez-Álvarez J, Jacob J, Gil V, Miró O, Llorens P, Martín-Sánchez FJ, Alquézar-Arbé A, Rodríguez-Adrada E, Romero-Pareja R, López-Diez P, Herrero-Puente P. Prognostic implications of Anemia in patients with acute heart failure in emergency departments. ANEM-AHF Study. Int J Clin Pract 2021; 75:e13712. [PMID: 32955782 DOI: 10.1111/ijcp.13712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/22/2020] [Accepted: 09/06/2020] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- M de Los Ángeles Fernández-Rodríguez
- Servicio de Hematología y Hemoterapia, Hospital Universitario Central de Asturias, Oviedo, Spain
- Grupo de Investigación en Urgencias y Emergencias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - B Prieto-García
- Grupo de Investigación en Urgencias y Emergencias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Área de Gestión Clínica del Laboratorio de Medicina, Hospital Universitario Central de Asturias, Oviedo, Spain
- Universidad de Oviedo, Oviedo, Spain
| | - J Vázquez-Álvarez
- Grupo de Investigación en Urgencias y Emergencias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Unidad de Gestión Clínica de Urgencias, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Jacob
- Servicio de Urgencias y Unidad de Corta Estancia, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - V Gil
- Área de Urgencias. Hospital Clinic, Barcelona, Grupo de Investigación "Urgencias: procesos y patologías", IDIBAPS, Barcelona, Spain
| | - O Miró
- Área de Urgencias. Hospital Clinic, Barcelona, Grupo de Investigación "Urgencias: procesos y patologías", IDIBAPS, Barcelona, Spain
| | - P Llorens
- Servicio de Urgencias-Corta Estancia y Hospitalización a domicilio, Hospital General Universitario de Alicante, Alicante, Spain
| | - F J Martín-Sánchez
- Servicio de Urgencias, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - A Alquézar-Arbé
- Servicio de Urgencias, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
| | - E Rodríguez-Adrada
- Servicio de Urgencias, Hospital Rey Juan Carlos de Móstoles, Madrid, Spain
| | - R Romero-Pareja
- Servicio de Urgencias, Hospital Universitario de Getafe, Madrid, Spain
| | - P López-Diez
- Servicio de Urgencias, Hospital Universitario de Burgos, Burgos, Spain
| | - P Herrero-Puente
- Grupo de Investigación en Urgencias y Emergencias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Universidad de Oviedo, Oviedo, Spain
- Unidad de Gestión Clínica de Urgencias, Hospital Universitario Central de Asturias, Oviedo, Spain
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