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Obstructive Lung Diseases |

Impact of Anemia on Ventilator Days and In-Hospital Mortality in Patients With COPD Exacerbation

Suresh Kumar Manickavel, MBBS; Kalpesh Patel, MD; Ayham Aboeed, MD; Nader Mahmood, MD; M. Khan, MD
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St Joseph's Regional Medical Center, Paterson, NJ


Chest. 2013;144(4_MeetingAbstracts):730A. doi:10.1378/chest.1703744
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Abstract

SESSION TITLE: COPD Treatment Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: COPD exacerbation is associated with significant morbidity and mortality. The current evidence regarding the effect of anemia on COPD exacerbation is inconclusive. Studies have shown that anemia may be associated with prolonged ventilator days. The purpose of the study is to evaluate the impact of anemia on ventilator days and in-hospital Mortality in patients with severe COPD exacerbation.

METHODS: A retrospective cohort study of the patients admitted to the hospital with COPD exacerbation requiring mechanical ventilation was conducted over a period from January 1, 2005 to August 30, 2012. Admitting data including hemoglobin concentration and baseline characteristics were collected. The cohort was divided depending on hemoglobin concentration (< 12 gm/dL and ≥ 12 gm/dL). Data on mechanical ventilator days and in-hospital mortality were collected.

RESULTS: There were 157 patients studied with a diagnosis of COPD exacerbation requiring mechanical ventilation. Out of which 102 patients had hemoglobin ≥ 12 gm/dL and the remaining 55 patients had hemoglobin < 12 gm/dL. In the anemia group 18 patients required mechanical ventilation ≥ 96 hours and in the control (non-anemia) group there were 29 patients. There was no significant difference in the proportion of patients requiring prolonged ventilation between the two groups (odds ratio (OR) is 1.23 and p-value = 0.59). Similarly no difference was noted in in-hospital mortality between the two groups with an OR of 1.40 and a p-value = 0.51. Potential confounders did not significantly interact.

CONCLUSIONS: Our study indicates that anemia did not significantly affect the duration of mechanical ventilation and in-hospital mortality in patients with severe COPD exacerbation. Current literature is conflicting on whether anemia can affect length of mechanical ventilation and mortality. Future studies are needed to determine whether anemia can play a prognostic role in COPD exacerbation.

CLINICAL IMPLICATIONS: Avoidance of unnecessary transfusions in critically ill patients with COPD exacerbation.

DISCLOSURE: The following authors have nothing to disclose: Suresh Kumar Manickavel, Kalpesh Patel, Ayham Aboeed, Nader Mahmood, M. Khan

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