title: Association between anemia and quality of life in a population sample of individuals with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Several studies investigated the association of anemia with health related quality of life (HRQL) in patients with chronic disease. However, there is little evidence regarding the association of anemia with HRQL in patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  This is a post-hoc analysis of a study which enrolled a population of adults aged 35-79 randomly selected from residents of Erie and Niagara Counties, NY, between 1996 and 2000. In addition to demographic information and physical measurements, we obtained spirometry data and hemoglobin levels. We used modified Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria to define COPD, and World Health Organization (WHO) criteria to define anemia. To assess HRQL we used the Short Form-36 (SF-36) to assess physical functioning (PF), physical component summary (PCS) measures and mental component summary (MCS) measures.
  
  
  RESULTS
  In the entire study population (n = 2704), respondents with anemia had lower scores on the physical functioning domain [45.4 (SD10.9) vs. 49.2 (SD 9.1); p < 0.0001]. Among patients with COPD (n = 495) the PF scores (39.9 vs. 45.4) and the PCS (41.9 vs. 45.9) were significantly lower in individuals with anemia compared to those without. In multiple regression analysis, the association between hemoglobin and PCS was positive (regression coefficient 0.02, p = 0.003). There was no significant association of hemoglobin with PF scores or the mental component summary measure after adjusting for covariates in patients with COPD.
  
  
  CONCLUSIONS
  In patients with moderate to very severe COPD anemia may be associated with worse HRQL. However, co-morbidities may explain part or all of this association in these patients.
authors.affiliation: Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA. drgokuldrish@hotmail.com
authors.forename: Gokul
authors.initials: G
authors.lastname: Krishnan
authors.forename: Brydon J
authors.initials: BJ
authors.lastname: Grant
authors.forename: Paola C
authors.initials: PC
authors.lastname: Muti
authors.forename: Archana
authors.initials: A
authors.lastname: Mishra
authors.forename: Heather M
authors.initials: HM
authors.lastname: Ochs-Balcom
authors.forename: Jo L
authors.initials: JL
authors.lastname: Freudenheim
authors.forename: Maurizio
authors.initials: M
authors.lastname: Trevisan
authors.forename: Holger J
authors.initials: HJ
authors.lastname: Schünemann
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000150:complications*; D005260:Female; D006304:Health Status; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology*; D011788:Quality of Life; D012720:Severity of Illness Index
chemical_list: D006454:Hemoglobins