PURPOSE: To determine frequency of anemia in COPD and its relations to the concomitant diseases, dyspnea status and severity of COPD.
METHODS: In 2008, 102 COPD patients in out-patient clinic were included prospectively. Age, gender, concomitant diseases, BMI, x-ray findings and smoking history were recorded. PFTs, WBC count test and MRC dyspnea scorrings were performed. Anemic ( WHO classification) patients were evaluated, anemia without spesific etiology was considered COPD-related-anemia. Chi-squre and Mann-Whitney U tests were used in statistical analysis.
RESULTS: Mean age of 98(96.1%) male and 4(3.9%) female patients was 61.8±10.9. Mean Hb:14.2±1.9 g/dl and mean Htc:35.1% was found. Mean FEV1(%pred) was 55.3±19.0 and FEV1/FVC was 51.1±11.0. Of cases, 47(46.1%) had concomitant disease(s) and hypertension was the leading (n=26, 25.5%) followed by coronary artery disease (n=18, 17.6%). Anemia (Htc< 36% for female, Htc< 39% for male) was found in 20(19.6%) patiens, of which 14(70%) were attributed to COPD after further evaluation. Iron deficiency (n=3) and active bleeding (n=3) were other anemia causes . Anemia was found in 27.6% and 12.7% cases with and without concomitant disease(s) respectively (p=0.048). COPD patients with hypertension had significantly more anemia than patients without hypertension. (34.6% vs. 14.4%, p=0.026). COPD stage-3,4 (GOLD stages) patiens had more frequent anemia (21.4%) compared to stage-1,2 (18.3%) without statistical significance. Also more dyspneic MRC scale 2-4 patients had more anemia (24.4%) compared to MRC scale 0-1 (15.0%) patients without statistical significance. COPD-related-anemia rates were gradually increasing as COPD severity increases from stage-1 to stage-4 (0%, 54.5%, 87.5% and 100%, respectively). COPD-related anemia rate was higher in COPD stage-3,4 (88.8%) when compared to COPD stage-1,2 (54.5%) (p=0.095). Policytemia was found in 5(4.9%) patients. There was no relation between anemia and spirometric values, chest x-ray findings, BMI, age and gender.
CONCLUSION: Anemia in COPD is unexpectedly frequent. Although concomitant diseases are related with anemia, COPD itself may cause anemia especially as the disease gets worse regarding COPD stages.
CLINICAL IMPLICATIONS: Anemia in addition to policytemia should be a part of evaluation of COPD patient.
DISCLOSURE: Ali Fidan, No Financial Disclosure Information; No Product/Research Disclosure Information