Prevalence and clinical impact of anemia in patients diagnosed with chronic obstructive pulmonary disease: A cross-sectional study

Suman Rimal; Santa K Das; Anita Basnet; Tej P Rauniyar; Kundan Raj Pandey; Sandip Kuikel

doi:10.1002/hsr2.1371

Prevalence and clinical impact of anemia in patients diagnosed with chronic obstructive pulmonary disease: A cross-sectional study

Health Sci Rep. 2023 Jun 27;6(6):e1371. doi: 10.1002/hsr2.1371. eCollection 2023 Jun.

Authors

Suman Rimal¹, Santa K Das², Anita Basnet³, Tej P Rauniyar¹, Kundan Raj Pandey¹, Sandip Kuikel⁴

Affiliations

¹ Department of Internal Medicine Tribhuvan University Institute of Medicine Kathmandu Nepal.
² Department of Pulmonology and Critical Care Tribhuvan University Institute of Medicine Kathmandu Nepal.
³ Department of Public Health Patan Academy of Health Sciences Lalitpur Nepal.
⁴ Sukraraj Tropical and Infectious Disease Hospital Kathmandu Nepal.

Abstract

Background and aims: Unlike classically described polycythemia, anemia is found to be more prevalent in patients with chronic obstructive pulmonary disease (COPD). Anemia increases the cost of hospital stay and causes an increased risk of adverse outcomes including death in COPD patients. This study was done to find the prevalence of anemia in COPD patients, the factors associated, and the outcomes of anemic COPD.

Methods: It was a quantitative, descriptive-analytical, and cross-sectional study conducted in Tribhuvan University Teaching Hospital's medical wards and the Emergency Room from September 2019 to September 2020. A simple random sampling method was used. Clinical information was obtained, and patients were followed up 3 months after discharge to document the number of exacerbations and deaths if present.

Results: The patients in our study had a mean age of 70.80 ± 11.16 years. Most were female. Most (85.5%) had a history of exposure to firewood smoke. Twenty-three percent of the patients had anemia and these patients had significantly greater mortality 3 months postdischarge. Middle-old and old were more likely to have anemia with odds ratio (OR) of 2.55 (confidence interval [CI]: 0.48-13.5) and 13.6 (CI: 1.12-24.2), respectively. Current smokers had less likelihood of having anemia (OR: 0.05, CI: 0.006-0.49). Multivariate analysis showed that age, sex, and smoking status were significant determinants of anemia in COPD. There was no association between anemia and duration of hospital stay. However, mortality was higher at 3 months in COPD patients with anemia (p < 0.001).

Conclusion: In COPD patients, anemia is prevalent comorbidity that is significantly linked to higher mortality but not to exacerbations. It is unknown, though, if treating anemia in COPD patients will affect the patient's outcome. Additional research in this area may be possible.

Keywords: COPD; anemia; chronic obstructive pulmonary disease; impact; prevalence.