Anemia como fator prognóstico em uma população hospitalizada por insuficiência cardíaca descompensada

Abstract

Objective: To study the prevalence and prognostic value of anemia in a population hospitalized due to decompensated heart failure. Methods From July to September, 2001, 204 patients were included in a multicenter hospital registry of heart failure (EPICA Study - Niterói). This retrospective analysis comprised 142 patients with data about hematocrit and hemoglobin levels collected on hospital admission. The mean age was 69.5±13.3 years, and 72 (50.7%) patients were men. Hemoglobin levels < 13.5 g/dL for men and < 12 g/dL for women were considered anemia. The relation between anemia and in-hospital mortality was assessed through univariate and multivariate analysis with logistic regression. Results: Anemia was observed in 89 (62.6%) patients, 52 (58%) men and 37 (42%) women. Mortality in anemic patients was 16.8% and, in nonanemic, it was 8% (P=0.11). In both sexes, the mortality rates in anemic and nonanemic patients were, respectively, 19.2% vs 0% (P=0.034) and 13.5% vs 12.2% (P=0.86). Through multivariate analysis, the following variables were found to be independently related to in-hospital mortality: hyponatremia [RR=7.0; 95% confidence interval (95% CI)=6.1 to 8.7; P=0.0001], anemia (RR=3.1, 95% CI=2.4 to 4.3; P=0.024), and presence of NYHA functional class IV (RR=1.9; 95% CI=1.3 to 2.6; P=0.04). Conclusion: In the population studied with decompensated heart failure, the presence of anemia was an independent marker of in-hospital mortality. Mortality in the group with anemia was significantly high among men.