Prognostic value of anemia in terms of disability and mortality in hospitalized geriatric patients: results from the CRIME study

Anemia, a common concern in geriatric population, is associated with several negative outcomes. The aim of this study was to investigate the independent prognostic value of anemia in the year after hospital discharge, analyzing its association with disability and mortality in a sample of older hospi...

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Main Authors: Gloria Brombo, Marta Dianin, Lara Bianchi, Andrea Corsonello, Antonio Cherubini, Carmelinda Ruggiero, Graziano Onder, Stefano Volpato
Format: Article
Language:English
Published: PAGEPress Publications 2016-04-01
Series:Geriatric Care
Subjects:
Online Access:http://www.pagepressjournals.org/index.php/gc/article/view/5803
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author Gloria Brombo
Marta Dianin
Lara Bianchi
Andrea Corsonello
Antonio Cherubini
Carmelinda Ruggiero
Graziano Onder
Stefano Volpato
author_facet Gloria Brombo
Marta Dianin
Lara Bianchi
Andrea Corsonello
Antonio Cherubini
Carmelinda Ruggiero
Graziano Onder
Stefano Volpato
author_sort Gloria Brombo
collection DOAJ
description Anemia, a common concern in geriatric population, is associated with several negative outcomes. The aim of this study was to investigate the independent prognostic value of anemia in the year after hospital discharge, analyzing its association with disability and mortality in a sample of older hospitalized patients. We evaluated 896 in-hospital older patients enrolled in the <em>CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients</em> (CRIME) study, with assessment of hemoglobin levels at hospital admission and with follow-up data. We analyzed the risk of developing disability (in patients without pre-existing disability in activities of the daily living) and the likelihood of death (in the entire sample) in the 12 months after discharge according to presence and degree of anemia (defined by sex-specific World Health Organization criteria). Mean age of study participants was 81.2±7.4 years, 57.8% had prevalent anemia. In unadjusted analysis, anemia was strongly associated with functional status and survival. Nevertheless, the increased risk of disability and death was influenced by the coexistence of several clinical conditions associated with anemia. Indeed, using multivariate logistic regression analysis adjusted for potential confounders, the association with disability was strongly attenuated [severe anemia odds ratio (OR) 1.86, 95% confidence interval (CI): 0.96-3.58, mild-moderate anemia OR 1.05, 95% CI: 0.62-1.80] and the relationship with mortality was no longer significant [severe anemia hazard ratio (HR) 1.13, 95% CI: 0.73-1.75, mild-moderate anemia HR 1.14, 95% CI: 0.78-1.67]. In older hospitalized patients, anemia, despite not influencing mortality, might have a significant disabling effect. Anemia should not be considered as an inevitable epiphenomenon of aging but a condition able to worsen the quality of life.
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spelling doaj.art-56d939cb1e764751b0026ea465f378f62022-12-22T00:20:49ZengPAGEPress PublicationsGeriatric Care2465-11092465-13972016-04-012110.4081/gc.2016.58034712Prognostic value of anemia in terms of disability and mortality in hospitalized geriatric patients: results from the CRIME studyGloria Brombo0Marta Dianin1Lara Bianchi2Andrea Corsonello3Antonio Cherubini4Carmelinda Ruggiero5Graziano Onder6Stefano Volpato7Department of Medical Sciences, University of FerraraDepartment of Medical Sciences, University of FerraraDepartment of Medical Sciences, University of FerraraUnit of Geriatric Pharmacoepidemiology, Research Hospital of Cosenza, Italian National Research Center on Aging (INRCA), CosenzaDepartment of Geriatrics, Research Hospital of Ancona, Italian National Research Center on Aging (INRCA), AnconaUnit of Geriatric, S. Maria della Misericordia Hospital, University of Perugia, PerugiaResearch Center on Aging, Catholic University of Sacred Heart, RomeDepartment of Medical Sciences, University of FerraraAnemia, a common concern in geriatric population, is associated with several negative outcomes. The aim of this study was to investigate the independent prognostic value of anemia in the year after hospital discharge, analyzing its association with disability and mortality in a sample of older hospitalized patients. We evaluated 896 in-hospital older patients enrolled in the <em>CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients</em> (CRIME) study, with assessment of hemoglobin levels at hospital admission and with follow-up data. We analyzed the risk of developing disability (in patients without pre-existing disability in activities of the daily living) and the likelihood of death (in the entire sample) in the 12 months after discharge according to presence and degree of anemia (defined by sex-specific World Health Organization criteria). Mean age of study participants was 81.2±7.4 years, 57.8% had prevalent anemia. In unadjusted analysis, anemia was strongly associated with functional status and survival. Nevertheless, the increased risk of disability and death was influenced by the coexistence of several clinical conditions associated with anemia. Indeed, using multivariate logistic regression analysis adjusted for potential confounders, the association with disability was strongly attenuated [severe anemia odds ratio (OR) 1.86, 95% confidence interval (CI): 0.96-3.58, mild-moderate anemia OR 1.05, 95% CI: 0.62-1.80] and the relationship with mortality was no longer significant [severe anemia hazard ratio (HR) 1.13, 95% CI: 0.73-1.75, mild-moderate anemia HR 1.14, 95% CI: 0.78-1.67]. In older hospitalized patients, anemia, despite not influencing mortality, might have a significant disabling effect. Anemia should not be considered as an inevitable epiphenomenon of aging but a condition able to worsen the quality of life.http://www.pagepressjournals.org/index.php/gc/article/view/5803Elderlyanemiadisabilitymortality.
spellingShingle Gloria Brombo
Marta Dianin
Lara Bianchi
Andrea Corsonello
Antonio Cherubini
Carmelinda Ruggiero
Graziano Onder
Stefano Volpato
Prognostic value of anemia in terms of disability and mortality in hospitalized geriatric patients: results from the CRIME study
Geriatric Care
Elderly
anemia
disability
mortality.
title Prognostic value of anemia in terms of disability and mortality in hospitalized geriatric patients: results from the CRIME study
title_full Prognostic value of anemia in terms of disability and mortality in hospitalized geriatric patients: results from the CRIME study
title_fullStr Prognostic value of anemia in terms of disability and mortality in hospitalized geriatric patients: results from the CRIME study
title_full_unstemmed Prognostic value of anemia in terms of disability and mortality in hospitalized geriatric patients: results from the CRIME study
title_short Prognostic value of anemia in terms of disability and mortality in hospitalized geriatric patients: results from the CRIME study
title_sort prognostic value of anemia in terms of disability and mortality in hospitalized geriatric patients results from the crime study
topic Elderly
anemia
disability
mortality.
url http://www.pagepressjournals.org/index.php/gc/article/view/5803
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