Association of anaemia and mortality in patients with acute pulmonary embolism.
This study aimed to evaluate the relationship between anaemia and pulmonary embolism (PE) prognosis. We analysed a cohort of 764 patients with acute PE referred to a single center for diagnosis and management. Patients were divided into groups by quartiles of haemoglobin (Hb): Hb < 11.7 g/dl; Hb 11.7 to 12.9 g/dl; Hb 13.0 to 14.1 g/dl; Hb > 14.1 g/dl. Patients had a mean Hb of 12.9 g/dl, and values ranged from to 4.3 to 19.5 g/dl. Lower Hb was associated with recent bleeding, an impaired haemodynamic profile and higher creatinine. Patients in the lower Hb quartiles more commonly had female gender (p < 0.001), a diagnosis of cancer (p < 0.001), and an indication for an inferior vena cava (IVC) filter (p < 0.002), compared to patients in the higher Hb quartiles. Patients in higher Hb quartiles had higher survival at three months (75%, 86%, 90% and 91% for lowest to highest quartiles, respectively). On multivariate analysis, adjusting for known PE prognostic factors, low Hb proved to be an independent predictor of mortality (hazard ratio [HR] 1.16, 95% confidence interval [CI] 1.05 to 1.28 for each decrease of 1 g/dl). Hb level remained an independent predictor of all-cause mortality when cancer patients were excluded from the analysis (adjusted HR 0.81; 95% CI, 0.66 to 0.99; p = 0.04). Moreover, patients with anaemia showed a higher risk of fatal PE (unadjusted HR 1.19, 95% CI 1.04 to 1.37). In conclusion, in patients with acute symptomatic PE, anaemia severity is associated with worsened survival.
Jiménez
David
D
Respiratory Department, Ramón y Cajal Hospital, Madrid, Spain. djc_69_98@yahoo.com
Escobar
Carlos
C
Martí
David
D
Díaz
Gema
G
César
Jesús
J
García-Avello
Angel
A
Sueiro
Antonio
A
Yusen
Roger D
RD
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood* / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011655:Pulmonary Embolism / Q000097:blood* / Q000401:mortality*; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
D006454:Hemoglobins