Anaemia is frequent in a variety of chronic disease, and is associated with poor survival. There is limited data on prevalence of anaemia and survival in patients with chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the prevalence of anaemia and association with survival in an unselected cohort of consecutive patients with COPD.
Medical records of all discharges in University Clinic between 2002 to 2007 were screened for COPD according to International Classification of Disease (ICD 10). Diagnosis was ascertained by detailed review of all available data and final sample consisted of 1185 patients (age 70±9y, men 72%, GOLD III/IV 63%). Medical records were reviewed for patient characteristics and vital status was obtained from Central Population Registry. WHO definition of anaemia was used: haemoglobin <12 g/dl in women and <13 g/dl in men.
Anaemia was present in 225 (19%) patients with COPD and was more prevalent in men when compared to women (21% vs 12%, p<0.001). Prevalence in GOLD stage I-IV was 10%, 21%, 16%, and 21%, respectively. During median follow-up of 36.5 months (IQR 19–57 months), 561 (47%) patients died. More patients with anaemia died (62% vs 44%, p<0.001). In univariable Cox proportional hazard model, anaemia (HR 1.93, 95% CI 1.60–2.36) and haemoglobin (HR 1.13, 95% CI 1.08–1.18 per 10g/l decrease) was associated with higher risk of death. After adjustment for age, gender, GOLD, renal function, cancer, and chronic heart failure, anaemia predicted death (HR 1.65, 95% CI 1.35–2.01).
Anaemia was present in 19% of patients with COPD and independently predicted death.
Anaemia seems to be an important comorbidity in COPD. Future research has to focus on aetiology and treatment strategies.
Mitja Lainscak, No Financial Disclosure Information; No Product/Research Disclosure Information