Clinical studyThe prognostic importance of anemia in patients with heart failure
Section snippets
Sample
Patients were selected from Medicare’s National Claims History File for 18 acute care Connecticut hospitals from 1994 to 1995. A consecutive sample of 200 patients aged 65 years or older per hospital (or all cases from institutions with fewer than 200 admissions) who had a principal discharge diagnosis of heart failure (International Classification of Diseases, Ninth Revision [ICD-9], Clinical Modification codes 428 to 428.1, 402.01, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, and 404.93)
Results
The mean (± SD) age of the 2281 study patients was 79 ± 8 years; 58% (n = 1324) were women, and 90% (n = 2054) were white. The majority of patients had a history of hypertension (60%, n = 1358) and heart failure (63%, n = 1432), and a substantial minority had diabetes (37%, n = 839), a history of myocardial infarction (37%, n = 832), or a history of renal insufficiency (20%, n = 463). The median value for hematocrit was 38% (25th to 75th percentiles: 33% to 42%). Hematocrits were higher in men (
Discussion
Our study demonstrates that anemia is an independent predictor of mortality in a representative group of hospitalized elderly patients with heart failure. The magnitude of this effect was similar to other well-accepted predictors of adverse outcome in these patients, such as left ventricular ejection fraction. Anemia was also a significant predictor of 1-year hospital readmission.
Previous studies have identified other adverse prognostic factors among patients with heart failure, including low
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