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Significado pronóstico de los valores de hemoglobina en pacientes con insuficiencia cardíaca

2005; Elsevier BV; Volume: 58; Issue: 1 Linguagem: Inglês

10.1157/13070508

1579-2242

Josep Lupón, Agustín Urrútia, Beatríz González, Juan Herreros, Salvador Altimir, Ramón Coll, Montserrat Prats, Celestino Rey‐Joly, Vicente Valle,

Cardiac Arrest and Resuscitation

Evaluar el valor pronóstico de las concentraciones de hemoglobina (Hb) en relación con la mortalidad y con los ingresos hospitalarios por insuficiencia cardíaca (IC) al año de la primera visita a la Unidad de IC. Conocemos la situación vital y los ingresos por IC al año en 337 pacientes admitidos entre agosto de 2001 y marzo de 2003. Las concentraciones de Hb se recogieron en la primera visita. Fallecieron 28 (8%) pacientes y hubo 158 ingresos por IC en 66 pacientes. Los valores de Hb se asociaron con la mortalidad a 1 año (pacientes vivos, 13,0 ± 1,7 g/dl; pacientes fallecidos, 11,6 ± 1,7 g/dl; p < 0,001) y con la necesidad de ingresar por IC (pacientes sin ingresos, 13,1 ± 1,7 g/dl; pacientes con al menos un ingreso, 12,2 ± 1,7 g/dl; p < 0,001). En el análisis multivariable, los valores de Hb mantuvieron la significación estadística. Definida la anemia como Hb < 12 g/dl, el 30% de los pacientes estaba anémico. La mortalidad al año fue del 17% en los pacientes anémicos y del 5% en el grupo sin anemia (p < 0,001). El 31% de los pacientes con anemia tuvo al menos un ingreso hospitalario por IC, mientras que sólo el 15% de los pacientes no anémicos precisó ingresar (p = 0,001). Los valores de Hb se asocian inversamente con la mortalidad y los ingresos por IC en el primer año de seguimiento. La prevalencia de anemia en nuestra población con IC es elevada y tiene valor pronóstico independiente. To evaluate the prognostic significance of hemoglobin (Hb) levels in terms of 1-year mortality and hospital admissions due to heart failure (HF) during the first year of follow-up after the first visit to an outpatient HF unit. Survival status and HF-related hospital admission rate at 1 year were analyzed for 337 patients admitted between August 2001 and March 2003. Plasma Hb level was measured at the first visit to the unit. 28 patients (8%) died and there were 158 H-Frelated hospital admissions in 66 patients. Plasma Hb level correlated strongly with survival at 1 year, and was 13.0 ± 1.7 g/dL in patients who were alive after this time, versus 11.7 ± 1.6 g/dL (P<.001) in patients who died. Plasma Hb level also correlated with HF-related need for hospital admission, and was 13.1 ± 1.7 g/dL in patients who were not hospitalized, versus 12.2 ± 1.7 g/dL (P<.001) in patients with at least one hospital admission. In the multivariate logistic regression analysis plasma Hb level remained statistically associated both with 1-year survival and with the need for HF-related hospital admission. On the basis of a cutoff value for anemia of Hb < 12 g/dL, 30% of the patients had anemia. One-year mortality was 17% in patients with anemia and 5% in patients without anemia (P<.001). Among patients without anemia, 31% had at least one HF-related hospital admission, whereas only a 15% of the patients without anemia needed to be hospitalized for HF (P=.001). Plasma Hb levels correlated inversely with mortality and with HF-related hospital admissions at 1 year. The prevalence of anemia (Hb < 12 g/dL) in the population with HF studied here was high and had independent prognostic value.