Cargando…

The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia

BACKGROUND: The prevalence of anemia in the intensive care unit is well-described. Less is known, however, of the prevalence of anemia in hospitalized patients with lesser illness severity or without organ dysfunction. Community-acquired pneumonia (CAP) is one of the most frequent reasons for hospit...

Descripción completa

Detalles Bibliográficos
Autores principales: Reade, Michael C, Weissfeld, Lisa, Angus, Derek C, Kellum, John A, Milbrandt, Eric B
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848211/
https://www.ncbi.nlm.nih.gov/pubmed/20233445
http://dx.doi.org/10.1186/1471-2466-10-15
_version_ 1782179658043752448
author Reade, Michael C
Weissfeld, Lisa
Angus, Derek C
Kellum, John A
Milbrandt, Eric B
author_facet Reade, Michael C
Weissfeld, Lisa
Angus, Derek C
Kellum, John A
Milbrandt, Eric B
author_sort Reade, Michael C
collection PubMed
description BACKGROUND: The prevalence of anemia in the intensive care unit is well-described. Less is known, however, of the prevalence of anemia in hospitalized patients with lesser illness severity or without organ dysfunction. Community-acquired pneumonia (CAP) is one of the most frequent reasons for hospitalization in the United States (US), affecting both healthy patients and those with comorbid illness, and is typically not associated with acute blood loss. Our objective was to examine the development and progression of anemia and its association with 90d mortality in 1893 subjects with CAP presenting to the emergency departments of 28 US academic and community hospitals. METHODS: We utilized hemoglobin values obtained for clinical purposes, classifying subjects into categories consisting of no anemia (hemoglobin >13 g/dL), at least borderline (≤ 13 g/dL), at least mild (≤ 12 g/dL), at least moderate (≤ 10 g/dL), and severe (≤ 8 g/dL) anemia. We stratified our results by gender, comorbidity, ICU admission, and development of severe sepsis. We used multivariable logistic regression to determine factors independently associated with the development of moderate to severe anemia and to examine the relationship between anemia and 90d mortality. RESULTS: A total of 8240 daily hemoglobin values were measured in 1893 subjects. Mean (SD) number of hemoglobin values per patient was 4.4 (4.0). One in three subjects (33.9%) had at least mild anemia at presentation, 3 in 5 (62.1%) were anemic at some point during their hospital stay, and 1 in 2 (54.5%) survivors were discharged from the hospital anemic. Anemia increased with illness severity and was more common in those with comorbid illnesses, female gender, and poor outcomes. Yet, even among men and in those with no comorbidity or only mild illness, anemia during hospitalization was common (~55% of subjects). When anemia was moderate to severe (≤ 10 g/dL), its development was independently associated with increased 90d mortality, even among hospital survivors. CONCLUSIONS: Anemia was common in hospitalized CAP and independently associated with 90d mortality when hemoglobin values were 10 g/dL or less. Whether prevention or treatment of CAP-associated anemia would improve clinical outcomes remains to be seen.
format Text
id pubmed-2848211
institution National Center for Biotechnology Information
language English
publishDate 2010
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-28482112010-04-01 The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia Reade, Michael C Weissfeld, Lisa Angus, Derek C Kellum, John A Milbrandt, Eric B BMC Pulm Med Research article BACKGROUND: The prevalence of anemia in the intensive care unit is well-described. Less is known, however, of the prevalence of anemia in hospitalized patients with lesser illness severity or without organ dysfunction. Community-acquired pneumonia (CAP) is one of the most frequent reasons for hospitalization in the United States (US), affecting both healthy patients and those with comorbid illness, and is typically not associated with acute blood loss. Our objective was to examine the development and progression of anemia and its association with 90d mortality in 1893 subjects with CAP presenting to the emergency departments of 28 US academic and community hospitals. METHODS: We utilized hemoglobin values obtained for clinical purposes, classifying subjects into categories consisting of no anemia (hemoglobin >13 g/dL), at least borderline (≤ 13 g/dL), at least mild (≤ 12 g/dL), at least moderate (≤ 10 g/dL), and severe (≤ 8 g/dL) anemia. We stratified our results by gender, comorbidity, ICU admission, and development of severe sepsis. We used multivariable logistic regression to determine factors independently associated with the development of moderate to severe anemia and to examine the relationship between anemia and 90d mortality. RESULTS: A total of 8240 daily hemoglobin values were measured in 1893 subjects. Mean (SD) number of hemoglobin values per patient was 4.4 (4.0). One in three subjects (33.9%) had at least mild anemia at presentation, 3 in 5 (62.1%) were anemic at some point during their hospital stay, and 1 in 2 (54.5%) survivors were discharged from the hospital anemic. Anemia increased with illness severity and was more common in those with comorbid illnesses, female gender, and poor outcomes. Yet, even among men and in those with no comorbidity or only mild illness, anemia during hospitalization was common (~55% of subjects). When anemia was moderate to severe (≤ 10 g/dL), its development was independently associated with increased 90d mortality, even among hospital survivors. CONCLUSIONS: Anemia was common in hospitalized CAP and independently associated with 90d mortality when hemoglobin values were 10 g/dL or less. Whether prevention or treatment of CAP-associated anemia would improve clinical outcomes remains to be seen. BioMed Central 2010-03-16 /pmc/articles/PMC2848211/ /pubmed/20233445 http://dx.doi.org/10.1186/1471-2466-10-15 Text en Copyright ©2010 Reade et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research article
Reade, Michael C
Weissfeld, Lisa
Angus, Derek C
Kellum, John A
Milbrandt, Eric B
The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia
title The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia
title_full The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia
title_fullStr The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia
title_full_unstemmed The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia
title_short The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia
title_sort prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia
topic Research article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848211/
https://www.ncbi.nlm.nih.gov/pubmed/20233445
http://dx.doi.org/10.1186/1471-2466-10-15
work_keys_str_mv AT reademichaelc theprevalenceofanemiaanditsassociationwith90daymortalityinhospitalizedcommunityacquiredpneumonia
AT weissfeldlisa theprevalenceofanemiaanditsassociationwith90daymortalityinhospitalizedcommunityacquiredpneumonia
AT angusderekc theprevalenceofanemiaanditsassociationwith90daymortalityinhospitalizedcommunityacquiredpneumonia
AT kellumjohna theprevalenceofanemiaanditsassociationwith90daymortalityinhospitalizedcommunityacquiredpneumonia
AT milbrandtericb theprevalenceofanemiaanditsassociationwith90daymortalityinhospitalizedcommunityacquiredpneumonia
AT reademichaelc prevalenceofanemiaanditsassociationwith90daymortalityinhospitalizedcommunityacquiredpneumonia
AT weissfeldlisa prevalenceofanemiaanditsassociationwith90daymortalityinhospitalizedcommunityacquiredpneumonia
AT angusderekc prevalenceofanemiaanditsassociationwith90daymortalityinhospitalizedcommunityacquiredpneumonia
AT kellumjohna prevalenceofanemiaanditsassociationwith90daymortalityinhospitalizedcommunityacquiredpneumonia
AT milbrandtericb prevalenceofanemiaanditsassociationwith90daymortalityinhospitalizedcommunityacquiredpneumonia