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.

Prognostic value of degree and types of anaemia on clinical outcomes for hospitalised older patients

MANFREDINI, Roberto
Membro del Collaboration Group
;
FABBIAN, Fabio
Membro del Collaboration Group
;
Valeria Raparelli
Membro del Collaboration Group
;
DE GIORGIO, Roberto
Membro del Collaboration Group
;
2017

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.
2017
Emma, Riva; Riccardo, Colombo; Guido, Moreo; Sara, Mandelli; Carlotta, Franchi; Luca, Pasina; Mauro, Tettamanti; Ugo, Lucca; Pier Mannuccio Mannucci, ; Alessandro, Nobili; Domenico, Prisco; Elena, Silvestri; Caterina, Cenci; Giacomo, Emmi; Gianni, Biolo; Gianfranco, Guarnieri; Michela, Zanetti; Giovanni, Fernandes; Massimo, Vanoli; Giulia, Grignani; Gianluca, Casella; Mauro, Bernardi; Silvia Li Bassi, ; Luca, Santi; Giacomo, Zaccherini; Elmo, Mannarino; Graziana, Lupattelli; Vanessa, Bianconi; Francesco, Paciullo; Ranuccio, Nuti; Roberto, Valenti; Martina, Ruvio; Silvia, Cappelli; Alberto, Palazzuoli; Teresa, Salvatore; Ferdinando Carlo Sasso, ; Domenico, Girelli; Oliviero, Olivieri; Thomas, Matteazzi; Mario, Barbagallo; Lidia, Plances; Roberta, Alcamo; Giuseppe, Licata; Luigi, Calvo; Maria, Valenti; Marco, Zoli; Raffaella, Arnò; Franco Laghi Pasini, ; Pier Leopoldo Capecchi, ; Maurizio, Bicchi; Giuseppe, Palasciano; Maria Ester Modeo, ; Maria, Peragine; Fabrizio, Pappagallo; Stefania, Pugliese; Carla Di Gennaro, ; Alfredo, Postiglione; Maria Rosaria Barbella, ; Francesco Di Stefano, ; Maria Domenica Cappellini, ; Giovanna, Fabio; Sonia, Seghezzi; Margherita Migone De Amicis, ; Daniela, Mari; Paolo Dionigi Rossi, ; Sarah, Diamanti; Barbara Brignolo Ottolini, ; Gino Roberto Corazza, ; Emanuela, Miceli; Marco Vincenzo Lenti, ; Donatella, Padula; Giovanni, Murialdo; Alessio, Marra; Federico, Cattaneo; Maria Beatrice Secchi, ; Davide, Ghelfi; Luigi, Anastasio; Lucia, Sofia; Maria, Carbone; Giovanni, Davì; Maria teresa Guagnano, ; Simona, Sestili; Gerardo, Mancuso; Daniela, Calipari; Mosè, Bartone; Maria Rachele Meroni, ; Paolo Cavallo Perin, ; Bartolomeo, Lorenzati; Gabriella, Gruden; Graziella, Bruno; Cristina, Amione; Paolo, Fornengo; Rodolfo, Tassara; Deborah, Melis; Lara, Rebella; Giuseppe, Delitala; Vincenzo, Pretti; Maristella Salvatora Masala, ; Luigi, Bolondi; Leonardo, Rasciti; Ilaria, Serio; Filippo Rossi Fanelli, ; Antonio, Amoroso; Alessio, Molfino; Enrico, Petrillo; Giuseppe, Zuccalà; Francesco, Franceschi; Guido De Marco, ; Cordischi, ; Marta, Sabbatini; Giuseppe, Romanelli; Claudia, Amolini; Deborah, Chiesa; Alessandra, Marengoni; Antonio, Picardi; Umberto Vespasiani Gentilucci, ; Paolo, Gallo; Giorgio, Annoni; Murizio, Corsi; Sara, Zazzetta; Giuseppe, Bellelli; Franco, Arturi; Elena, Succurro; Mariangela, Rubino; Giorgio, Sesti; Paola, Loria; Maria Angela Becchi, ; Gianfranco, Martucci; Alessandra, Fantuzzi; Mauro, Maurantonio; Giuseppe, Delitala; Stefano, Carta; Sebastiana, Atzori; Maria Grazia Serra, ; Maria Antonietta Bleve, ; Laura, Gasbarrone; Maria Rosaria Sajeva, ; Antonio, Brucato; Silvia, Ghidoni; Paola Di Corato, ; Giancarlo, Agnelli; Emanuela, Marchesini; Fabrizio, Fabris; Michela, Carlon; Francesca, Turatto; Aldo, Baritusso; Manfredini, Roberto; Christian, Molino; Marco, Pala; Fabbian, Fabio; Benedetta, Boari; Alfredo De Giorgi, ; Giuseppe, Paolisso; Maria Rosaria Rizzo, ; Maria Teresa Laieta, ; Giovanbattista, Rini; Pasquale, Mansueto; Ilenia, Pepe; Claudio, Borghi; Enrico, Strocchi; Valeria De Sando, ; Carlo, Sabbà; Francesco Saverio Vella, ; Patrizia, Soppressa; Raffaella, Valerio; Stefania, Pugliese; Caterina, Capobianco; Luigi, Fenoglio; Christian, Bracco; Alessia Valentina Giraudo, ; Elisa, Testa; Cristina, Serraino; Silvia, Fargion; Paola, Bonara; Giulia, Periti; Marianna, Porzio; Flora, Peyvandi; Alberto, Tedeschi; Raffaella, Rossio; Valter, Monzani; Valeria, Savojardo; Chritian, Folli; Maria, Magnini; Francesco, Salerno; Alessio, Conca; Giulia, Gobbo; Balduini, Carlo L.; Giampiera, Bertolino; Stella, Provini; Federica, Qualglia; Franco, Dallegri; Luciano, Ottonello; Luca, Liberale; Wu Sheng Chin, ; Laura, Carassale; Silvia, Caporotundo; Giancarlo, Traisci; Lucrezia De Feudis, ; Silvia Di Carlo, ; Nicola Lucio Liberato, ; Alberto, Buratti; Tiziana, Tognin; Giovanni Battista Bianchi, ; Sabrina, Giaquinto; Francesco, Purrello; Antonino Di Pino, ; Salvatore, Piro; Renzo, Rozzini; Lina, Falanga; Giuseppe, Montrucchio; Elisabetta, Greco; Pietro, Tizzani; Paolo, Petitti; Antonio, Perciccante; Alessia, Coralli; Raffaella, Salmi; Piergiorgio, Gaudenzi; Susanna, Gamberini; Andrea, Semplicini; Lucia, Gottardo; Gianluigi, Vendemiale; Gaetano, Serviddio; Roberta, Forlano; Cesare, Masala; Antonio, Mammarella; Raparelli, Valeria; Francesco, Violi; Stefania, Basili; Ludovica, Perri; Raffaele, Landolfi; Massimo, Montalto; Antonio, Mirijello; Carla, Vallone; Martino, Bellusci; Donatella, Setti; Filippo, Pedrazzoli; Luigina, Guasti; Luana, Castiglioni; Andrea, Maresca; Alessandro, Squizzato; Marta, Molaro; Marco, Bertolotti; Chiara, Mussi; Maria Vittoria Libbra, ; Andrea, Miceli; Elisa, Pellegrini; Lucia, Carulli; Francesco, Perticone; Angela, Sciacqua; Michele, Quero; Chiara, Bagnato; Roberto, Corinaldesi; DE GIORGIO, Roberto; Mauro, Serra; Valentina, Grasso; Eugenio, Ruggeri; Andrea, Salvi; Roberto, Leonardi; Chiara, Grassini; Ilenia, Mascherona; Giorgio, Minelli; Francesca, Maltese; Armando, Gabrielli; Massimo, Mattioli; William, Capeci; Giuseppe Pio Martino, ; Salvatore, Corrao; Silvia, Messina; Riccardi, Ghio; Serena, Favorini; Anna Dal Col, ; Salvatore, Minisola; Luciano, Colangelo; Antonella, Afeltra; Pamela, Alemanno; Benedetta, Marigliano; Pietro, Castellino; Julien, Blanco; Luca, Zanoli; Marco, Cattaneo; Paola, Fracasso; Maria Valentina Amoruso, ; Valter, Saracco; Marisa, Fogliati; Carlo, Bussolino; Vittorio, Durante; Giovanna, Eusebi; Daniela, Tirotta; Francesca, Mete; Miriam, Gino; Antonio, Cittadini; Michele, Arcopinto; Andrea, Salzano; Emanuele, Bobbio; Alberto Maria Marra, ; Domenico, Sirico; Guido, Moreo; Francesco, Scopelliti; Francesca, Gasparini; Melissa, Cocca; Ramirez Duque Nieves, ; Muela Molinero Alberto, ; Abad Requejo Pedro, ; Lopez Pelaez Vanessa, ; Tamargo, Lara; Corbella Viros Xavier, ; Formiga, Francesc; Diez Manglano Jesus, ; Bejarano Tello Esperanza, ; Del Corral Behamonte Esther, ; Sevil Puras Maria, ; Manuel, Romero; Pinilla Llorente Barca, ; Lopez Gonzales Cobos Cristina, ; Victoria, Villalba Garcia M.; Lopez, Saez; Juan, Bosco; Saenz Baena Susana, ; Arroyo Gallego Marta, ; Gonzalez Becerra Concepcion, ; Fernandez Moyano Antonio, ; Mercedez Gomez Hernandez, ; Manuel Poyato Borrego, ; Pacheco Cuadros Raquel, ; Perez Rojas Florencia, ; Garcia Olid Beatriz, ; Carrascosa Garcia sara, ; Gonzalez Cruz Cervellera Alfonso, ; Peinado Martinez Marta, ; Ruiz Cantero Alberto, ; Albarracin Arraigosa Antonio, ; Godoy Guerrero Montserrat, ; Baron Ramos Miguel Angel, ; Machin Jose Manuel, ; Novo Valeiro Igancio, ; Alvela Suarez Lucia, ; Lopez, Alfonso; Rubal Bran David, ; Iniguez Vazquez Iria, ; Rios Prego Monica,
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