Key Words: chronic obstructive pulmonary disease, exacerbation, anemia
Abstract
Background
The presence of anemia in chronic obstructive pulmonary disease is not an infrequent event. Exacerbations of this disease have been associated with an increase in mortality in these patients. It is not clear if the presence of anemia is associated with the risk of exacerbations.
Objective
To establish the association between anemia and the incidence of outcomes related to exacerbations of chronic obstructive pulmonary disease.
Methods
Analytical study of a dynamic or open concurrent prospective cohort of patients diagnosed with chronic obstructive pulmonary disease at two health care institutions in Cartagena, Colombia, between July 2010 and July 2011.
Results
43.9% had anemia at the start of follow-up. The cumulative incidence of exacerbations was 63% in the anemic vs. 55.5% in the non-anemic group. The cumulative incidence of recurrence of exacerbations was 30.4% in the anemic vs. 38.8% in the non-anemic group. The rate of hospitalizations for exacerbations was 30.4% in the anemic vs. 33.3% in the non-anemic group.
Conclusions
No significant association was established between anemia and the incidence of exacerbations of chronic obstructive pulmonary disease, the incidence of recurrence of first exacerbation, the rate of hospitalizations for chronic obstructive pulmonary disease exacerbations and the recurrence time of the first exacerbation of chronic obstructive pulmonary disease.
This article does not have an English version.
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Introducción
La presencia de anemia en la enfermedad pulmonar obstructiva crónica es un hecho frecuente. Las exacerbaciones de esta enfermedad se han asociado a un incremento de la mortalidad en estos pacientes. No es claro si la presencia de anemia se vincula al riesgo de exacerbaciones.
Objetivo
Establecer la asociación entre anemia e incidencia de desenlaces relacionados con las exacerbaciones de la enfermedad pulmonar obstructiva crónica.
Métodos
Estudio analítico de una cohorte dinámica o abierta, prospectiva y concurrente de pacientes con diagnóstico de enfermedad pulmonar obstructiva crónica de dos instituciones de atención en salud de Cartagena, Colombia, entre julio de 2010 y julio de 2011.
Resultados
De los casos revisados, 43,9% presentó anemia al inicio del seguimiento. La incidencia acumulada de exacerbaciones fue de 63% en el grupo de pacientes anémicos versus 55,5% en el grupo de no anémicos. La incidencia acumulada de recurrencia de exacerbaciones fue de 30,4% en el grupo de anémicos versus 38,8% en el grupo de no anémicos. La tasa de hospitalizaciones por exacerbaciones fue de 30,4% en el grupo de anémicos versus 33,3% en el grupo de no anémicos.
Conclusiones
No se estableció asociación significativa entre la anemia y la incidencia de exacerbaciones de enfermedad pulmonar obstructiva crónica, la incidencia de recurrencia de la primera exacerbación, la tasa de hospitalizaciones por exacerbaciones de enfermedad pulmonar obstructiva crónica y el tiempo hasta la recurrencia de la primera exacerbación de enfermedad pulmonar obstructiva crónica.
Authors:
Pablo Andrés Miranda Machado[1], Iván Baños Álvarez[2], Hernando Guillermo Gaitán Duarte[3]
Affiliation:
[1] ALZAK Foundation, Cartagena, Colombia
[2] Centro de Rehabilitación Pulmonar, Cartagena, Colombia
[3] Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
E-mail: mmpa9@hotmail.com
Citation: Miranda Machado PA, Baños Álvarez I, Gaitán Duarte HG. Association between anemia and chronic obstructive pulmonary disease exacerbations in Cartagena Colombia: a prospective cohort study. Medwave 2019;19(2):e7602 doi: 10.5867/medwave.2019.02.7602
Submission date: 13/9/2018
Acceptance date: 6/3/2019
Publication date: 26/3/2019
Origin: not commissioned
Type of review: reviewed by four external peer reviewers, double-blind
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- Hoepers AT, Menezes MM, Fröde TS. Systematic review of anaemia and inflammatory markers in chronic obstructive pulmonary disease. Clin Exp Pharmacol Physiol. 2015 Mar;42(3):231-9. | CrossRef | PubMed |
- Calle Rubio M, Chacón BM, Rodríguez Hermosa JL. [Exacerbation of chronic obstructive pulmonary disease]. Arch Bronconeumol. 2010 Oct;46 Suppl 7:21-5. | CrossRef | PubMed |
- Schols AM, Slangen J, Volovics L, Wouters EF. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998 Jun;157(6 Pt 1):1791-7. | PubMed |
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- Tassiopoulos S, Kontos A, Konstantopoulos K, Hadzistavrou C, Vaiopoulos G, Aessopos A, et al. Erythropoietic response to hypoxaemia in diffuse idiopathic pulmonary fibrosis, as opposed to chronic obstructive pulmonary disease. Respir Med. 2001 Jun;95(6):471-5. | PubMed |
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- Martinez-Rivera C, Portillo K, Muñoz-Ferrer A, Martínez-Ortiz ML, Molins E, Serra P, et al. Anemia is a mortality predictor in hospitalized patients for COPD exacerbation. COPD. 2012 Jun;9(3):243-50. | CrossRef | PubMed |
Mirza S, Clay RD, Koslow MA, Scanlon PD. COPD Guidelines: A Review of the 2018 GOLD Report. Mayo Clin Proc. 2018 Oct;93(10):1488-1502. | CrossRef | PubMed |Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997 May 24;349(9064):1498-504. | PubMed |Quaderi SA, Hurst JR. The unmet global burden of COPD. Glob Health Epidemiol Genom. 2018 Apr 6;3:e4. | CrossRef | PubMed |Caballero A, Torres-Duque CA, Jaramillo C, Bolívar F, Sanabria F, Osorio P,et al. Prevalence of COPD in five Colombian cities situated at low, medium, and high altitude (PREPOCOL study). Chest. 2008 Feb;133(2):343-9. | PubMed |Carroz KP. [Anemia in COPD: should it be taken into consideration?]. Arch Bronconeumol. 2007 Jul;43(7):392-8. | PubMed |Soler-Cataluña JJ, Martínez-García MÁ, Serra PC. [Multidimensional impact of COPD exacerbations]. Arch Bronconeumol. 2010 Dec;46 Suppl 11:12-9. | CrossRef | PubMed |Hoepers AT, Menezes MM, Fröde TS. Systematic review of anaemia and inflammatory markers in chronic obstructive pulmonary disease. Clin Exp Pharmacol Physiol. 2015 Mar;42(3):231-9. | CrossRef | PubMed |Calle Rubio M, Chacón BM, Rodríguez Hermosa JL. [Exacerbation of chronic obstructive pulmonary disease]. Arch Bronconeumol. 2010 Oct;46 Suppl 7:21-5. | CrossRef | PubMed |Schols AM, Slangen J, Volovics L, Wouters EF. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998 Jun;157(6 Pt 1):1791-7. | PubMed |Prescott E, Almdal T, Mikkelsen KL, Tofteng CL, Vestbo J, Lange P. Prognostic value of weight change in chronic obstructive pulmonary disease: results from the Copenhagen City Heart Study. Eur Respir J. 2002 Sep;20(3):539-44. | PubMed |Oga T, Nishimura K, Tsukino M, Sato S, Hajiro T. Analysis of the Factors Related to Mortality in Chronic Obstructive Pulmonary Disease. J Respir Crit Care Med. 2003 Feb 15;167(4):544-9. | CrossRef | PubMed |Ezekowitz JA, McAlister FA, Armstrong PW. Anemia is common in heart failure and is associated with poor outcomes: insights from a cohort of 12 065 patients with new-onset heart failure. Circulation. 2003 Jan 21;107(2):223-5. | PubMed |Tassiopoulos S, Kontos A, Konstantopoulos K, Hadzistavrou C, Vaiopoulos G, Aessopos A, et al. Erythropoietic response to hypoxaemia in diffuse idiopathic pulmonary fibrosis, as opposed to chronic obstructive pulmonary disease. Respir Med. 2001 Jun;95(6):471-5. | PubMed |John M, Hoernig S, Doehner W, Okonko DD, Witt C, Anker SD. Anemia and inflammation in COPD. Chest. 2005 Mar;127(3):825-9. | PubMed |Méndez Bailón M, Rivas NM, De J, Díez M, Luis J, Walther Á-S. Anemia inflamatoria y enfermedad pulmonar obstructiva crónica: Una asociación a veces olvidada. Medicinarespiratoria2008;2(1):37-42. | Link |Ergan B, Ergün R. Impact of anemia on short-term survival in severe COPD exacerbations: a cohort study. Int J Chron Obstruct Pulmon Dis. 2016 Aug 1;11:1775-83. | CrossRef | PubMed |Pirotte M, Guiot J, Beguin Y, Louis R. [Anemia in patients with severe chronic obstructive pulmonary disease, a comorbity more common than previously thought]. Rev Med Liege. 2016 Nov;71(11):488-494. | PubMed |Portillo K, Belda J, Antón P, Casan P. [High frequency of anemia in COPD patients admitted in a tertiary hospital]. Rev Clin Esp. 2007 Sep;207(8):383-7. | CrossRef | PubMed |Ferrari M, Manea L, Anton K, Bruzzone P, Meneghello M, Zamboni F, et al. Anemia and hemoglobin serum levels are associated with exercise capacity and quality of life in chronic obstructive pulmonary disease. BMC Pulm Med. 2015 May 8;15:58. | CrossRef | PubMed |Menezes AMB, Perez-Padilla R, Jardim JB, Muiño A, Lopez MV, Valdivia G, et al. Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study. Lancet. 2005 Nov 26;366(9500):1875-81. | CrossRef | PubMed |Boutou AK, Hopkinson NS, Polkey MI. Anaemia in chronic obstructive pulmonary disease: an insight into its prevalence and pathophysiology. Clin Sci (Lond). 2015 Mar;128(5):283-95. | CrossRef | PubMed |Sarkar M, Rajta PN, Khatana J. Anemia in Chronic obstructive pulmonary disease: Prevalence, pathogenesis, and potential impact. Lung India. 2015 Mar-Apr;32(2):142-51. | CrossRef | PubMed |Budnevsky AV, Esaulenko IE, Ovsyannikov ES, Zhusina YG. [Anemias in chronic obstructive pulmonary disease]. Ter Arkh. 2016;88(3):96-99. | CrossRef | PubMed |Boutou AK, Stanopoulos I, Pitsiou GG, Kontakiotis T, Kyriazis G, Sichletidis L, et al. Anemia of chronic disease in chronic obstructive pulmonary disease: a case-control study of cardiopulmonary exercise responses. Respiration. 2011;82(3):237-45. | CrossRef | PubMed |Frank Y, Regev A, Novack V, Avnon L, Avriel A, Shimonovich F, et al. [Incidence of hospitalizations among chronic obstructive pulmonary disease (COPD) patients with anemia]. Harefuah. 2012 Apr;151(4):211-5, 254. | PubMed |Barba R, Casasola GG de, Marco J, Emilio Losa J, Plaza S, Canora J, et al. Anemia in chronic obstructive pulmonary disease: a readmission prognosis factor. Curr Med Res Opin. 2012 Apr 28;28(4):617-22. | CrossRef |
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