engleski

Anemia does not affect the short-term outcome in acute exacerbation of advanced chronic heart failure

Purpose: Heart failure is a major cause of mortality and morbidity, while anemia is a frequent comorbidity in chronic heart failure with significant impact on the long-term outcome. Our aim was to assess the prognostic value of anemia on short-term outcome in acute worsening of advanced, but prior stable chronic heart failure. Methods: We performed retrospective study of 263 consecutive patients hospitalised for acute exacerbation of decompensated chronic heart failure, New York Heart Association functional class 3 and 4, whose ejection fraction measured by echocardiography was ≤ 40%. All of these patients were stable more than 30 days prior to hospitalisation. Among these patients 138 (73 female) had anemia and 125 were without anemia (64 female). Anemia was defined by WHO criteria, as hemoglobin at admission <120 g/l for women and <130 g/l for men. Statistical analysis included comparison of demographic, clinical, laboratory and therapeutic data between these two groups, with an emphasis on 30-days mortality rate. All patients had optimal therapy in accordance with the actual ESC guidelines and anemia was treated if indicated. Results: Patients in both groups were similar age (77, 5 ±8 vs. 75±9, 8 years, p=0, 067) and had average length of hospital stay around 8 days (8 [95% C.I. 89-93]vs.8 [95% C.I. 90-94], P=0.817). Although 30-days mortality rate was higher in anemic patients, that difference was not statistically significant (11.4% vs. 9.5%, P=0.764). Hemoglobin concentration at admission is not in corelation with 30-days mortality in male (P=0.472) neither female (P=0.767) patients. The group of anemic patients had significantly wider QRS complex (118ms [95% C.I. 96-124] vs. 92ms [95% C.I. 84-109], P=0.013), higher concentration of urea (11.8 mmol/l [95% C.I. 10.2-13.5] vs. 9.2 mmol/l [95% C.I. 8.6], P=0.015) and creatinine (139μmol/l [95% C.I. 128-155] vs. 111 μmol/l [95% C.I. 107-125], P<0.001) than nonanemic patients. Oxygen saturation slightly differed between the groups (88, 67% vs. 88, 48% P=0.817). Conclusion: In according to our results anemia does not affect the short-term outcome in patients hospitalised for acute worsening of advanced chronic heart failure.

heart failure; anemia; prognosis

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