title: Anemia is a mortality predictor in hospitalized patients for COPD exacerbation.
abstract: BACKGROUND
  Anemia is a recognized prognostic factor in many chronic illnesses, but there is limited information about its impact on outcomes in patients hospitalized for acute COPD exacerbation (AECOPD).
  
  
  OBJECTIVE
  To investigate whether anemia exerts an effect on mortality in patients admitted for AECOPD after one year of follow-up. Methods. From November 2007 to November 2009 we recruited 117 patients who required hospitalization due to an AECOPD. Clinical, functional and laboratory parameters on admission were prospectively assessed. Patients were followed up during one year. Mortality and days-to-death were collected.
  
  
  RESULTS
  Mean age 72 (SD ± 9); FEV₁ 37.4 (SD ± 12); mortality after 1 year was 22.2%. Mean survival: 339 days. Comparing patients who died to those who survived we found significant differences (p < 0,000) in hemoglobin (Hb) (12.4 vs 13.8 mg/dl) and hematocrit (Ht) (38 vs 41%). Anemia (Hb < 13 g.dl⁻¹) prevalence was 33%. Those who died had experienced 3.5 exacerbations in previous year vs 1.5 exacerbations in the case of the survivors (p = 0.000). Lung function and nutritional status were similar, except for percentage of muscle mass (%) (35 vs 39%; p = 0.015) and albumin (33 vs 37 mg/dl; p = 0.039). These variables were included in a Multivariate Cox Proportional Hazards Model; anemia and previous exacerbations resulted as independent factors for mortality. Mortality risk for patients with anemia was 5.9(CI: 1.9-19); for patients with > 1 exacerbation in the previous year was 5.9(CI: 1.3-26.5).
  
  
  CONCLUSIONS
  Anemia and previous exacerbations were independent predictors of mortality after one year in patients hospitalized for AECOPD.
authors.affiliation: Department of Pulmonary Medicine, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain. 29002cmr@comb.cat
authors.forename: Carlos
authors.initials: C
authors.lastname: Martinez-Rivera
authors.forename: Karina
authors.initials: K
authors.lastname: Portillo
authors.forename: Aida
authors.initials: A
authors.lastname: Muñoz-Ferrer
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Martínez-Ortiz
authors.forename: Elena
authors.initials: E
authors.lastname: Molins
authors.forename: Pere
authors.initials: P
authors.lastname: Serra
authors.forename: Joan
authors.initials: J
authors.lastname: Ruiz-Manzano
authors.forename: Josep
authors.initials: J
authors.lastname: Morera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications*; D018450:Disease Progression; D004909:Erythrocyte Indices; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000401:mortality*