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. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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; Prisco, Domenico; Silvestri, Elena; Cenci, Caterina; Barnini, Tommaso; Delitala, Giuseppe; Carta, Stefano; Atzori, Sebastiana; Guarnieri, Gianfranco; Zanetti, Michela; Spalluti, Annalisa; Grazia Serra, Maria; Antonietta Bleve, Maria; Vanoli, Massimo; Grignani, Giulia; Casella, Gianluca; Gasbarrone, Laura; Maniscalco, Giorgio; Gunelli, Massimo; Tirotta, Daniela; Brucato, Antonio; Ghidoni, Silvia; Di Corato, Paola; Bernardi, Mauro; Li Bassi, Silvia; Santi, Luca; Agnelli, Giancarlo; Iorio, Alfonso; Marcucci, Maura; Marchesini, Emanuela; Mannarino, Elmo; Lupattelli, Graziana; Rondelli, Pamela; Paciullo, Francesco; Fabris, Fabrizio; Carlon, Michela; Turatto, Francesca; Cristina Baroni, Maria; Zardo, Marianna; Manfredini, Roberto; Molino, Christian; Pala, Marco; Fabbian, Fabio; Nuti, Ranuccio; Valenti, Roberto; Ruvio, Martina; Cappelli, Silvia; Paolisso, Giuseppe; Rosaria Rizzo, Maria; Teresa Laieta, Maria; Salvatore, Teresa; Carlo Sasso, Ferdinando; Utili, Riccardo; Durante Mangoni, Emanuele; Pinto, Daniela; Olivieri, Oliviero; Maria Stanzial, Anna; Fellin, Renato; Volpato, Stefano; Fotini, Sioulis; Barbagallo, Mario; Dominguez, Ligia; Plances, Lidia; D'Angelo, Daniela; Rini, Giovanbattista; Mansueto, Pasquale; Pepe, Ilenia; Licata, Giuseppe; Calvo, Luigi; Valenti, Maria; Borghi, Claudio; Strocchi, Enrico; Rebecca Rinaldi, Elisa; Zoli, Marco; Fabbri, Elisa; Magalotti, Donatella; Auteri, Alberto; Laura Pasqui, Anna; Puccetti, Luca; Laghi Pasini, Franco; Leopoldo Capecchi, Pier; Bicchi, Maurizio; Sabbà, Carlo; Saverio Vella, Francesco; Marseglia, Alessandro; Valentina Luglio, Chiara; Palasciano, Giuseppe; Ester Modeo, Maria; Aquilino, Annamaria; Raffaele, Pallante; Pugliese, Stefania; Capobianco, Caterina; Postiglione, Alfredo; Rosaria Barbella, Maria; De Stefano, Francesco; Fenoglio, Luigi; Brignone, Chiara; Bracco, Christian; Giraudo, Alessia; Musca, Giuseppe; Cuccurullo, Olga; Cricco, Luigi; Fiorentini, Alessandra; Domenica Cappellini, Maria; Fabio, Giovanna; Seghezzi, Sonia; Migone De Amicis, Margherita; Fargion, Silvia; Bonara, Paola; Bulgheroni, Mara; Lombardi, Rosa; Magrini, Fabio; Massari, Ferdinando; Tonella, Tatiana; Peyvandi, Flora; Tedeschi, Alberto; Monzani, Valter; Savojardo, Valeria; Folli, Christian; Magnini, Maria; Mari, Daniela; Dionigi Rossi, Paolo; Damanti, Sarah; Prolo, Silvia; Sole Lilleri, Maria; Cricco, Luigi; Fiorentini, Alessandra; Micale, Giuliana; Podda, Mauro; Selmi, Carlo; Francesca, ; Salerno, Francesco; Accordino, Silvia; Conca, Alessio; Monti, Valentina; Roberto Corazza, Gino; Miceli, Emanuela; Vincenzo Lenti, Marco; Padula, Donatella; Balduini, Carlo L.; Bertolino, Giampiera; Provini, Stella; Quaglia, Federica; Murialdo, Giovanni; Bovio, Marta; Dallegri, Franco; Ottonello, Luciano; Quercioli, Alessandra; Barreca, Alessandra; Beatrice Secchi, Maria; Ghelfi, Davide; Sheng Chin, Wu; Carassale, Laura; Caporotundo, Silvia; Anastasio, Luigi; Sofia, Lucia; Carbone, Maria; Traisci, Giancarlo; De Feudis, Lucrezia; Di Carlo, Silvia; Davì, Giovanni; Teresa Guagnano, Maria; Sestili, Simona; Bergami, Elisabetta; Rizzioli, Emanuela; Cagnoni, Carlo; Bertone, Luca; Manucra, Antonio; Buratti, Alberto; Tognin, Tiziana; Lucio Liberato, Nicola; Bernasconi, Giordano; Nardo, Barbara; Battista Bianchi, Giovanni; Giaquinto, Sabrina; Benetti, Giampiero; Quagliolo, Michela; Riccardo Centenaro, Giuseppe; Purrello, Francesco; Di Pino, Antonino; Piro, Salvatore; Mancuso, Gerardo; Calipari, Daniela; Bartone, Mosè; Gullo, Francesco; Cortellaro, Michele; Magenta, Marina; Perego, Francesca; Rachele Meroni, Maria; Cicardi, Marco; Gidaro Marina Magenta, Antonio; Sacco, Andrea; Bonelli, Antonio; Dentamaro, Gaetano; Rozzini, Renzo; Falanga, Lina; Giordano, Alessandro; Cavallo Perin, Paolo; Lorenzati, Bartolomeo; Gruden, Gabriella; Bruno, Graziella; Greco, Elisabetta; Tizzani, Pietro; Fera, Giacomo; Loreta Di Luca, Maria; Renna, Donatella; Perciccante, Antonio; Coralli, Alessia; Tassara, Rodolfo; Melis, Deborah; Rebella, Lara; Menardo, Giorgio; Bottone, Stefania; Sferrazzo, Elsa; Ferri, Claudio; Striuli, Rinaldo; Scipioni, Rosa; Salmi, Raffaella; Gaudenzi, Piergiorgio; Gamberini, Susanna; Ricci, Franco; Morabito, Cosimo; Fava, Roberto; Semplicini, Andrea; Gottardo, Lucia; Delitala, Giuseppe; Carta, Stefano; Atzori, Sebastiana; Vendemiale, Gianluigi; Serviddio, Gaetano; Forlano, Roberta; Bolondi, Luigi; Rasciti, Leonardo; Serio, Ilaria; Masala, Cesare; Mammarella, Antonio; Raparelli, Valeria; Rossi Fanelli, Filippo; Delfino, Massimo; Amoroso, Antonio; Violi, Francesco; Basili, Stefania; Perri, Ludovica; Serra, Pietro; Fontana, Vincenzo; Falcone, Marco; Landolfi, Raffaele; Grieco, Antonio; Gallo, Antonella; Zuccalà, Giuseppe; Franceschi, Francesco; De Marco, Guido; Chiara, Cordischi; Marta, Sabbatini; Bellusci, Martino; Setti, Donatella; Pedrazzoli, Filippo; Romanelli, Giuseppe; Pirali, Caterina; Amolini, Claudia; Agabiti Rosei, Enrico; Rizzoni, Damiano; Castoldi, Luana; Picardi, Antonio; Vespasiani, Umberto; Gentilucci, ; Mazzarelli, Chiara; Gallo, Paolo; Guasti, Luigina; Castiglioni, Luana; Maresca, Andrea; Squizzato, Alessandro; Contini, Sara; Molaro, Marta; Annoni, Giorgio; Corsi Sara Zazzetta, Maurizio; Bertolotti, Marco; Mussi, Chiara; Scotto, Roberto; Alice Ferri, Maria; Veltri, Francesca; Arturi, Franco; Succurro, Elena; Sesti, Giorgio; Gualtieri Francesco Perticone, Umberto; Sciacqua, Angela; Quero, Michele; Bagnato, Chiara; Loria, Paola; Angela Becchi, Maria; Martucci, Gianfranco; Fantuzzi, Alessandra; Maurantonio, Mauro; Corinaldesi, Roberto; De Giorgio, Roberto; Serra, Mauro; Grasso, Valentina; Ruggeri, Eugenio; Mauro Carozza, Lorenzo; Pignatti., Fabio. - In: ARCHIVES OF GERONTOLOGY AND GERIATRICS. - ISSN 0167-4943. - 69:(2017), pp. 21-30. [10.1016/j.archger.2016.11.005]
Prognostic value of degree and types of anaemia on clinical outcomes for hospitalised older patients
Francesco Paciullo;Sarah Damanti;
2017-01-01
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. (C) 2016 Elsevier Ireland Ltd. All rights reserved.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
