title: Parameters influencing in-hospital mortality in patients hospitalized in intensive cardiac care unit: is there an influence of anemia and iron deficiency?
abstract: We investigated the incidence and prognostic value of anemia as well as of the iron status in non-selected patients admitted to an intensive cardiac care unit (ICCU). 392 patients (mean age 70 ± 13.8 years, 43% women), 168 with acute coronary syndromes (ACS), 122 with acute decompensated heart failure, and 102 with other acute cardiac disorders were consecutively, prospectively assessed. The biomarkers of iron status-serum iron concentration (SIC), total iron binding capacity (TIBC), and transferrin saturation (TSAT) together with standard clinical, biochemical and echocardiographic variables-were analyzed. In-hospital mortality was 3.8% (15 patients). The prevalences of anemia (according to WHO criteria), and iron deficiency (ID) were 64 and 63%, respectively. The level of biomarkers of iron status, but not anemia, was lower in patients who died (p < 0.05). Anemia was less frequent in patients with ACS as compared to the remaining ICCU population (p = 0.019). The analysis by logistic regression indicated the highest risk of death for age [odds ratio (OD) 1.38, 95% CI 1.27-1.55], SIC (OR 0.85, 95% CI 0.78-0.94), TIBC (OR 0.95, 95% CI 0.91-0.98), left ventricle ejection fraction (OR 0.85, 95% CI 0.77-0.93), as well as hospitalization for non-ACS (OR 0.25, 95% CI 0.14-0.46), (p < 0.05). The risk of death during hospitalization tended to increase with decreasing levels of TIBC (p = 0.49), as well as with the absence of ACS (p = 0.54). The incidence of anemia and ID in heterogeneous ICCU patients is high. Parameters of the iron status, but not anemia per se, independently influence in-hospital mortality. The prevalence of anemia is higher in non-ACS patients, and tends to worsen the prognosis.
authors.affiliation: Department of Cardiology, Medical University of Bialystok, ul. Sklodowskiej-Curie 24a, 15-276, Bialystok, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Uscinska
authors.forename: Bozena
authors.initials: B
authors.lastname: Sobkowicz
authors.forename: Robert
authors.initials: R
authors.lastname: Sawicki
authors.forename: Izabela
authors.initials: I
authors.lastname: Kiluk
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Baranicz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Stepek
authors.forename: Milena
authors.initials: M
authors.lastname: Dabrowska
authors.forename: Maciej
authors.initials: M
authors.lastname: Szmitkowski
authors.forename: Wlodzimierz J
authors.initials: WJ
authors.lastname: Musial
authors.forename: Agnieszka M
authors.initials: AM
authors.lastname: Tycinska
mesh_terms: D000368:Aged; D000740:Anemia / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008297:Male; D011044:Poland / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D007501:Iron