Prognostic value of degree and types of anaemia on clinical outcomes for hospitalised older patients

Emma Riva, Riccardo Colombo, Guido Moreo, Sara Mandelli, Carlotta Franchi, Luca Pasina, Mauro Tettamanti, Ugo Lucca, Pier Mannuccio Mannucci, Alessandro Nobili

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)21-30
Number of pages10
JournalArchives of Gerontology and Geriatrics
Volume69
DOIs
Publication statusPublished - Mar 1 2017

Keywords

  • Anaemia
  • Clinical outcomes
  • Older in-patients

ASJC Scopus subject areas

  • Health(social science)
  • Ageing
  • Gerontology
  • Geriatrics and Gerontology

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