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Anemia: an independent predictor of death and hospitalizations among elderly patients with atrial fibrillation.
Am Heart J. 2009 Jun; 157(6):1057-63.AH

Abstract

BACKGROUND

Anemia and atrial fibrillation (AF) are common among the elderly. Anemia is an independent predictor of mortality and morbidity for numerous cardiovascular and noncardiovascular diseases, but the association of anemia with mortality and hospitalizations in patients with AF requires clarification.

METHODS

Subjects were 13,067 Medicare beneficiaries hospitalized with AF and included in the National Registry of Atrial Fibrillation II data set. Index hospitalization hematocrit (Hct) was obtained by structured chart abstraction. Cox proportional hazards models quantified the association of Hct with mortality and re-hospitalizations during a median follow-up period of 12 months.

RESULTS

The mean age was 79.8 years, 58% were women, and the mean Hct was 39.2%. Hematocrit was significantly (P < .0001) associated with risk of death and of rehospitalization even after adjustment for demographic information, comorbid conditions, and use of cardiovascular medications. As compared to a Hct of 40% to 44.9%, the adjusted hazard ratios for mortality were 1.66 for Hct <25%, 1.50 for 25% to 29.9%, 1.28 for 30% to 34.9%, 1.07 for 35% to 39.9%, 1.03 for 45% to 49.9%, and 1.10 for > or = 50%. The association between anemia and mortality was significant in men and women but stronger in men (P = .006 for interaction). Compared to the category 40% to 44.9%, the risk of rehospitalization was increased to 28% (adjusted hazard ratio 1.28, 95% CI 1.15-1.43) in the Hct category 25% to 29.9%.

CONCLUSION

Anemia is an independent predictor of mortality and of hospitalizations in elderly patients with AF. Studies are needed to assess the effect of treatment of anemia on clinical outcomes.

Authors+Show Affiliations

Washington University in St. Louis School of Medicine Barnes-Jewish Hospital, St. Louis, MO, USA. ssharma@dom.wustl.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19464417

Citation

Sharma, Shivak, et al. "Anemia: an Independent Predictor of Death and Hospitalizations Among Elderly Patients With Atrial Fibrillation." American Heart Journal, vol. 157, no. 6, 2009, pp. 1057-63.
Sharma S, Gage BF, Deych E, et al. Anemia: an independent predictor of death and hospitalizations among elderly patients with atrial fibrillation. Am Heart J. 2009;157(6):1057-63.
Sharma, S., Gage, B. F., Deych, E., & Rich, M. W. (2009). Anemia: an independent predictor of death and hospitalizations among elderly patients with atrial fibrillation. American Heart Journal, 157(6), 1057-63. https://doi.org/10.1016/j.ahj.2009.03.009
Sharma S, et al. Anemia: an Independent Predictor of Death and Hospitalizations Among Elderly Patients With Atrial Fibrillation. Am Heart J. 2009;157(6):1057-63. PubMed PMID: 19464417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anemia: an independent predictor of death and hospitalizations among elderly patients with atrial fibrillation. AU - Sharma,Shivak, AU - Gage,Brian F, AU - Deych,Elena, AU - Rich,Michael W, Y1 - 2009/04/25/ PY - 2008/09/03/received PY - 2009/03/05/accepted PY - 2009/5/26/entrez PY - 2009/5/26/pubmed PY - 2009/6/17/medline SP - 1057 EP - 63 JF - American heart journal JO - Am Heart J VL - 157 IS - 6 N2 - BACKGROUND: Anemia and atrial fibrillation (AF) are common among the elderly. Anemia is an independent predictor of mortality and morbidity for numerous cardiovascular and noncardiovascular diseases, but the association of anemia with mortality and hospitalizations in patients with AF requires clarification. METHODS: Subjects were 13,067 Medicare beneficiaries hospitalized with AF and included in the National Registry of Atrial Fibrillation II data set. Index hospitalization hematocrit (Hct) was obtained by structured chart abstraction. Cox proportional hazards models quantified the association of Hct with mortality and re-hospitalizations during a median follow-up period of 12 months. RESULTS: The mean age was 79.8 years, 58% were women, and the mean Hct was 39.2%. Hematocrit was significantly (P < .0001) associated with risk of death and of rehospitalization even after adjustment for demographic information, comorbid conditions, and use of cardiovascular medications. As compared to a Hct of 40% to 44.9%, the adjusted hazard ratios for mortality were 1.66 for Hct <25%, 1.50 for 25% to 29.9%, 1.28 for 30% to 34.9%, 1.07 for 35% to 39.9%, 1.03 for 45% to 49.9%, and 1.10 for > or = 50%. The association between anemia and mortality was significant in men and women but stronger in men (P = .006 for interaction). Compared to the category 40% to 44.9%, the risk of rehospitalization was increased to 28% (adjusted hazard ratio 1.28, 95% CI 1.15-1.43) in the Hct category 25% to 29.9%. CONCLUSION: Anemia is an independent predictor of mortality and of hospitalizations in elderly patients with AF. Studies are needed to assess the effect of treatment of anemia on clinical outcomes. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/19464417/Anemia:_an_independent_predictor_of_death_and_hospitalizations_among_elderly_patients_with_atrial_fibrillation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(09)00164-1 DB - PRIME DP - Unbound Medicine ER -