Study objective This study investigated in a large sample of in-patients the impact of mild-moderate-severe anaemia on clinical outcomes such as in-hospital mortality, re-admission, and death within three months after discharge. Methods A prospective multicentre observational study, involving older people admitted to 87 internal medicine and geriatric wards, was done in Italy between 2010 and 2012. The main clinical/laboratory data were obtained on admission and discharge. Based on haemoglobin (Hb), subjects were classified in three groups: group 1 with normal Hb, (reference group), group 2 with mildly reduced Hb (10.0–11.9 g/dL in women; 10.0–12.9 g/dL in men) and group 3 with moderately-severely reduced Hb (<10 g/dL in women and men). Results Patients (2678; mean age 79.2 ± 7.4 y) with anaemia (54.7%) were older, with greater functional impairment and more comorbidity. Multivariable analysis showed that mild but not moderate-severe anaemia was associated with a higher risk of hospital re-admission within three months (group 2: OR = 1.62; 95%CI 1.21–2.17). Anaemia failed to predict in-hospital mortality, while a higher risk of dying within three months was associated with the degree of Hb reduction on admission (group 2: OR = 1.82;95%CI 1.25–2.67; group 3: OR = 2.78;95%CI 1.82–4.26) and discharge (group 2: OR = 2.37;95%CI 1.48–3.93; group 3: OR = 3.70;95%CI 2.14–6.52). Normocytic and macrocytic, but not microcytic anaemia, were associated with adverse clinical outcomes. Conclusions Mild anaemia predicted hospital re-admission of older in-patients, while three-month mortality risk increased proportionally with anaemia severity. Type and severity of anaemia affected hospital re-admission and mortality, the worst prognosis being associated with normocytic and macrocytic anaemia.
Prognostic Value of Degree and Types of Anaemia on Clinical Outcomes for Hospitalised Older Patients / Riva E.; Colombo R.; Moreo G.; Mandelli S.; Franchi C.; Pasina L.; Tettamanti M.; Lucca U.; Mannucci P.M.; Nobili A.; Perticone F.; Salerno F.; Corrao S.; Marengoni A.; Licata G.; Violi F.; Corazza G.R.; Marcucci M.; Eldin T.K.; Di Blanca M.P.D.; Djade C.D.; Ardoino I.; Cortesi L.; Prisco D.; Silvestri E.; Cenci C.; Emmi G.; Biolo G.; Guarnieri G.; Zanetti M.; Fernandes G.; Vanoli M.; Grignani G.; Casella G.; Bernardi M.; Li Bassi S.; Santi L.; Zaccherini G.; Mannarino E.; Lupattelli G.; Bianconi V.; Paciullo F.; Nuti R.; Valenti R.; Ruvio M.; Cappelli S.; Palazzuoli A.; Salvatore T.; Sasso F.C.; Girelli D.; Olivieri O.; Matteazzi T.; Barbagallo M.; Plances L.; Alcamo R.; Licata G.; Calvo L.; Valenti M.; Zoli M.; Arno R.; Pasini F.L.; Capecchi P.L.; Bicchi M.; Palasciano G.; Modeo M.E.; Peragine M.; Pappagallo F.; Pugliese S.; Di Gennaro C.; Postiglione A.; Barbella M.R.; De Stefano F.; Cappellini M.D.; Fabio G.; Seghezzi S.; De Amicis M.M.; Mari D.; Rossi P.D.; Damanti S.; Ottolini B.B.; Damanti S.; Corazza G.R.; Miceli E.; Lenti M.V.; Padula D.; Murialdo G.; Marra A.; Cattaneo F.; Secchi M.B.; Ghelfi D.; Anastasio L.; Sofia L.; Carbone M.; Davi G.; Guagnano M.T.; Sestili S.; Mancuso G.; Calipari D.; Bartone M.; Meroni M.R.; Perin P.C.; Lorenzati B.; Gruden G.; Bruno G.; Amione C.; Fornengo P.; Tassara R.; Melis D.; Rebella L.; Delitala G.; Pretti V.; Masala M.S.; Bolondi L.; Rasciti L.; Serio I.; Fanelli F.R.; Amoroso A.; Molfino A.; Petrillo E.; Zuccala G.; Franceschi F.; De Marco G.; Chiara C.; Marta S.; Romanelli G.; Amolini C.; Chiesa D.; Marengoni A.; Picardi A.; Gentilucci U.V.; Gallo P.; Annoni G.; Corsi M.; Zazzetta S.; Bellelli G.; Arturi F.; Succurro E.; Rubino M.; Sesti G.; Loria P.; Becchi M.A.; Martucci G.; Fantuzzi A.; Maurantonio M.; Delitala G.; Carta S.; Atzori S.; Serra M.G.; Bleve M.A.; Gasbarrone L.; Sajeva M.R.; Brucato A.; Ghidoni S.; Di Corato P.; Agnelli G.; Marchesini E.; Fabris F.; Carlon M.; Turatto F.; Baritusso A.; Turatto F.; Manfredini R.; Molino C.; Pala M.; Fabbian F.; Boari B.; De Giorgi A.; Paolisso G.; Rizzo M.R.; Laieta M.T.; Rini G.; Mansueto P.; Pepe I.; Borghi C.; Strocchi E.; De Sando V.; Sabba C.; Vella F.S.; Suppressa P.; Valerio R.; Pugliese S.; Capobianco C.; Fenoglio L.; Bracco C.; Giraudo A.V.; Testa E.; Serraino C.; Fargion S.; Bonara P.; Periti G.; Porzio M.; Peyvandi F.; Tedeschi A.; Rossio R.; Monzani V.; Savojardo V.; Folli C.; Magnini M.; Salerno F.; Conca A.; Gobbo G.; Conca A.; Balduini C.L.; Bertolino G.; Provini S.; Quaglia F.; Dallegri F.; Ottonello L.; Liberale L.; Chin W.S.; Carassale L.; Caporotundo S.; Traisci G.; De Feudis L.; Di Carlo S.; Liberato N.L.; Buratti A.; Tognin T.; Bianchi G.B.; Giaquinto S.; Purrello F.; Di Pino A.; Piro S.; Rozzini R.; Falanga L.; Montrucchio G.; Greco E.; Tizzani P.; Petitti P.; Perciccante A.; Coralli A.; Salmi R.; Gaudenzi P.; Gamberini S.; Semplicini A.; Gottardo L.; Vendemiale G.; Serviddio G.; Forlano R.; Masala C.; Mammarella A.; Raparelli V.; Violi F.; Basili S.; Perri L.; Landolfi R.; Montalto M.; Mirijello A.; Vallone C.; Bellusci M.; Setti D.; Pedrazzoli F.; Guasti L.; Castiglioni L.; Maresca A.; Squizzato A.; Molaro M.; Bertolotti M.; Mussi C.; Libbra M.V.; Miceli A.; Pellegrini E.; Carulli L.; Perticone F.; Sciacqua A.; Quero M.; Bagnato C.; Corinaldesi R.; De Giorgio R.; Serra M.; Grasso V.; Ruggeri E.; Salvi A.; Leonardi R.; Grassini C.; Mascherona I.; Minelli G.; Maltese F.; Gabrielli A.; Mattioli M.; Capeci W.; Martino G.P.; Corrao S.; Messina S.; Ghio R.; Favorini S.; Dal Col A.; Minisola S.; Colangelo L.; Afeltra A.; Alemanno P.; Marigliano B.; Castellino P.; Blanco J.; Zanoli L.; Cattaneo M.; Fracasso P.; Amoruso M.V.; Saracco V.; Fogliati M.; Bussolino C.; Durante V.; Eusebi G.; Tirotta D.; Mete F.; Gino M.; Cittadini A.; Arcopinto M.; Salzano A.; Bobbio E.; Marra A.M.; Sirico D.; Scopelliti F.; Gasparini F.; Cocca M.; Nieves R.D.; Alberto M.M.; Pedro A.R.; Vanessa L.P.; Lara T.; Xavier C.V.; Francesc F.; Jesus D.M.; Esperanza B.T.; Esther D.C.B.; Maria S.P.; Romero M.; Blanca P.L.; Cristina L.G.-C.; Victoria V.G.M.; Saez L.; Bosco J.; Susana S.B.; Marta A.G.; Concepcion G.B.; Antonio F.M.; Hernandez M.G.; Borrego M.P.; Raquel P.C.; Florencia P.R.; Beatriz G.O.; Sara C.G.; Alfonso G.-C.C.; Marta P.M.; Alberto R.C.; Antonio A.A.; Montserrat G.G.; Angel B.R.M.; Manuel M.J.; Ignacio N.V.; Lucia A.S.; Alfonso L.; David R.B.; Iria I.V.; Monica R.P.. - In: ARCHIVES OF GERONTOLOGY AND GERIATRICS. - ISSN 0167-4943. - ELETTRONICO. - 69:(2017), pp. 21-30. [10.1016/j.archger.2016.11.005]
Prognostic Value of Degree and Types of Anaemia on Clinical Outcomes for Hospitalised Older Patients
Riva E.;Colombo R.;Licata G.;Cortesi L.;Prisco D.;Silvestri E.;Cenci C.;Emmi G.;Fernandes G.;Salvatore T.;Licata G.;Pugliese S.;De Stefano F.;Padula D.;Picardi A.;Bellelli G.;Rubino M.;Loria P.;Fabris F.;Carlon M.;Molino C.;De Giorgi A.;Mansueto P.;Pepe I.;Borghi C.;Pugliese S.;Testa E.;Carassale L.;Di Carlo S.;Serviddio G.;Masala C.;Vallone C.;Setti D.;Serra M.;Ruggeri E.;Colangelo L.;Fracasso P.;Gasparini F.;Romero M.;
2017
Abstract
Study objective This study investigated in a large sample of in-patients the impact of mild-moderate-severe anaemia on clinical outcomes such as in-hospital mortality, re-admission, and death within three months after discharge. Methods A prospective multicentre observational study, involving older people admitted to 87 internal medicine and geriatric wards, was done in Italy between 2010 and 2012. The main clinical/laboratory data were obtained on admission and discharge. Based on haemoglobin (Hb), subjects were classified in three groups: group 1 with normal Hb, (reference group), group 2 with mildly reduced Hb (10.0–11.9 g/dL in women; 10.0–12.9 g/dL in men) and group 3 with moderately-severely reduced Hb (<10 g/dL in women and men). Results Patients (2678; mean age 79.2 ± 7.4 y) with anaemia (54.7%) were older, with greater functional impairment and more comorbidity. Multivariable analysis showed that mild but not moderate-severe anaemia was associated with a higher risk of hospital re-admission within three months (group 2: OR = 1.62; 95%CI 1.21–2.17). Anaemia failed to predict in-hospital mortality, while a higher risk of dying within three months was associated with the degree of Hb reduction on admission (group 2: OR = 1.82;95%CI 1.25–2.67; group 3: OR = 2.78;95%CI 1.82–4.26) and discharge (group 2: OR = 2.37;95%CI 1.48–3.93; group 3: OR = 3.70;95%CI 2.14–6.52). Normocytic and macrocytic, but not microcytic anaemia, were associated with adverse clinical outcomes. Conclusions Mild anaemia predicted hospital re-admission of older in-patients, while three-month mortality risk increased proportionally with anaemia severity. Type and severity of anaemia affected hospital re-admission and mortality, the worst prognosis being associated with normocytic and macrocytic anaemia.I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.