Mild anaemia is associated with increased all-cause mortality in heart failure.
OBJECTIVE
To evaluate the association of anaemia with increased long-term morbidity and mortality in hospitalised heart failure (HF) patients.


RESULTS
We analysed medical records of a random sample of 1000 patients admitted to tertiary care hospitals from 1996 to 2006 with a principal diagnosis of HF. Anaemia (WHO criteria) on admission was present in 45.2% of HF patients. Multivariate analysis identified anaemia as an independent predictor of 5-year mortality with a hazard ratio (HR) of 1.44 (95%CI 1.20-1.73) compared to non-anaemic patients, and a rate ratio of 1.85 (95%CI 1.72-2.02) for unplanned all-cause readmission and 1.22 (95%CI 1.16-1.29) for HF readmission within 5 years. Compared to patients in the highest gender-specific Hb quartile, those with mild anaemia (Hb 11.3-13.0 g/dL in males, 11.0-12.4 g/dL in females) had an adjusted HR of 1.32 (95%CI 1.01-1.71) for 5-year mortality. Anaemia and chronic kidney disease were independent (additive) predictors of survival, whereas anaemia interacted with prevalent diabetes (p for interaction=0.006), such that patients with both conditions had an adjusted mortality HR of 2.18 (95%CI 1.48-3.22) compared to those with diabetes only.


CONCLUSIONS
Mild anaemia is common in hospitalised HF patients and is an independent predictor of 5-year all-cause mortality in HF.
School of Population Health, University of Western Australia, Perth, Western Australia, Australia.
Tiew-Hwa Katherine
TH
Teng
Judith
J
Finn
Joseph
J
Hung
D000368:Aged; D000740:Anemia / Q000453:epidemiology / Q000401:mortality*; D016001:Confidence Intervals; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014904:Western Australia / Q000453:epidemiology