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Impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an Australian retrospective observational study

OBJECTIVES: Anaemia is associated with increased mortality in acute pulmonary embolism (PE) patients. However, prior studies have not examined the prognostic impact of trends in plasma haemoglobin during admission. This study investigates the impact of changes in haemoglobin level on mortality durin...

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Autores principales: Chow, Wallace, Wong, Christopher, Lau, Jerrett K, Chow, Vincent, Kritharides, Leonard, Ng, Austin C C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502010/
https://www.ncbi.nlm.nih.gov/pubmed/31048446
http://dx.doi.org/10.1136/bmjopen-2018-027112
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author Chow, Wallace
Wong, Christopher
Lau, Jerrett K
Chow, Vincent
Kritharides, Leonard
Ng, Austin C C
author_facet Chow, Wallace
Wong, Christopher
Lau, Jerrett K
Chow, Vincent
Kritharides, Leonard
Ng, Austin C C
author_sort Chow, Wallace
collection PubMed
description OBJECTIVES: Anaemia is associated with increased mortality in acute pulmonary embolism (PE) patients. However, prior studies have not examined the prognostic impact of trends in plasma haemoglobin during admission. This study investigates the impact of changes in haemoglobin level on mortality during hospital stay in acute PE. STUDY DESIGN: A retrospective observational study. SETTING: Tertiary-referral centre in Australia. PARTICIPANTS: Consecutive patients from 2000 to 2012 admitted with confirmed acute PE were identified from a dedicated PE database. Haemoglobin levels on days 1, 3–4, 5–6 and 7 of admission were retrieved. Patients without both baseline haemoglobin and subsequent haemoglobin levels were excluded (n=327), leaving 1099 patients as the study cohort. Anaemia was defined as haemoglobin <130 g/L for men and <120 g/L for women. There were 576 patients without anaemia throughout admission, 65 with transient anaemia (anaemic on day 1, but subsequently normalised during admission), 122 with acquired anaemia (normal on day 1 but developed anaemia during admission) and 336 with persistent anaemia. A total of 71 patients received blood transfusion during admission. MAIN OUTCOME MEASURE: 6-month mortality was tracked from a state-wide death database and analysed using multivariable modelling. RESULTS: After adjusting for transfusion, patietns with persistent anaemia had a significantly increased 6-month mortality risk (adjusted HR 1.97, 95% CI 1.26 to 3.09, p=0.003) compared with patients without anaemia. There was no difference in mortality between patients with transient or acquired anaemia and patients without anaemia. CONCLUSION: Among patients who had anaemia during their admission for acute PE, only the subgroup with persistent anaemia demonstrated worse outcomes.
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spelling pubmed-65020102019-05-21 Impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an Australian retrospective observational study Chow, Wallace Wong, Christopher Lau, Jerrett K Chow, Vincent Kritharides, Leonard Ng, Austin C C BMJ Open Respiratory Medicine OBJECTIVES: Anaemia is associated with increased mortality in acute pulmonary embolism (PE) patients. However, prior studies have not examined the prognostic impact of trends in plasma haemoglobin during admission. This study investigates the impact of changes in haemoglobin level on mortality during hospital stay in acute PE. STUDY DESIGN: A retrospective observational study. SETTING: Tertiary-referral centre in Australia. PARTICIPANTS: Consecutive patients from 2000 to 2012 admitted with confirmed acute PE were identified from a dedicated PE database. Haemoglobin levels on days 1, 3–4, 5–6 and 7 of admission were retrieved. Patients without both baseline haemoglobin and subsequent haemoglobin levels were excluded (n=327), leaving 1099 patients as the study cohort. Anaemia was defined as haemoglobin <130 g/L for men and <120 g/L for women. There were 576 patients without anaemia throughout admission, 65 with transient anaemia (anaemic on day 1, but subsequently normalised during admission), 122 with acquired anaemia (normal on day 1 but developed anaemia during admission) and 336 with persistent anaemia. A total of 71 patients received blood transfusion during admission. MAIN OUTCOME MEASURE: 6-month mortality was tracked from a state-wide death database and analysed using multivariable modelling. RESULTS: After adjusting for transfusion, patietns with persistent anaemia had a significantly increased 6-month mortality risk (adjusted HR 1.97, 95% CI 1.26 to 3.09, p=0.003) compared with patients without anaemia. There was no difference in mortality between patients with transient or acquired anaemia and patients without anaemia. CONCLUSION: Among patients who had anaemia during their admission for acute PE, only the subgroup with persistent anaemia demonstrated worse outcomes. BMJ Publishing Group 2019-05-01 /pmc/articles/PMC6502010/ /pubmed/31048446 http://dx.doi.org/10.1136/bmjopen-2018-027112 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Respiratory Medicine
Chow, Wallace
Wong, Christopher
Lau, Jerrett K
Chow, Vincent
Kritharides, Leonard
Ng, Austin C C
Impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an Australian retrospective observational study
title Impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an Australian retrospective observational study
title_full Impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an Australian retrospective observational study
title_fullStr Impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an Australian retrospective observational study
title_full_unstemmed Impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an Australian retrospective observational study
title_short Impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an Australian retrospective observational study
title_sort impact of persistent anaemia on mortality in patients hospitalised with acute pulmonary embolism: an australian retrospective observational study
topic Respiratory Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502010/
https://www.ncbi.nlm.nih.gov/pubmed/31048446
http://dx.doi.org/10.1136/bmjopen-2018-027112
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