The Influence of Anemia on Mortality in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Objective: The aim of this study was to determine the frequency of anemia and evaluate the impact of anemia on survival in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: Records of patient followed up with a diagnosis of COPD between 01 January 2004 and 31 December 2008 were extracted from hospital database by using ICD-10 codes. Anemia was diagnosed according to the definitions of the World Health Organization. COPD was staged according to GOLD criteria based on FEV1/FVC levels. Mortality was defined as death at any time from 1 January 2004 to 1 January 2010. Results: A total of 452 patients were included in the study. The 222 (49.1%) patients died. Anemia was detected in 145 (32.07%) of the patients. When death and surviving patients were compared; age, hemoglobin levels, FEV1 and FEV1% were statistically different. Severe and very severe COPD was detected in 76.1% of the dead patients while this rate was 60.5% in patients who survived (p<0.001). Solid tumour was more common in patients who died (p<0.001). Anemic patients were older than polycythemic patients and the normal hemoglobin group (p=0.017), while there were no statistically significant differences for FEV1, FEV1% and FEV1/FEV1%. The mortality rate was higher in patients with anemia than patients with polycythemia and normal hemoglobin level (p=0.002). Severe and very severe COPD were detected in 62.8% of anemic patients, 72.7% of polycythemic patients and 70.3% of the patients with normal hemoglobin. These rates were not statistically different between the three groups. Conclusion: According to the results of this retrospective study, anemia was more prevalent than polycythemia in patients with COPD and the mortality rate was higher in anemic patients. In addition, the mortality rate increased when FEV1 values decreased.