Title: Anaemia in Patients with Chronic Obstructive Pulmonary Disease Admitted In a Tertiary Health Care Centre in Kerala

Authors: Dr Devika Nandakumar, Dr H Poornima, Dr P S Shajahan

 DOI: https://dx.doi.org/10.18535/jmscr/v11i1.03

Abstract

Background: Polycythemia, traditionally thought to be highly prevalent in COPD, occurs less frequently nowadays with more rigorous correction of hypoxaemia.  Conversely, recent reports suggest that anaemia in patients with COPD is highly prevalent and associated with increased mortality. The purpose of the present study is to determine the prevalence of abnormalities in Hb levels in patients with COPD attending a tertiary health care centre in Kerala, as well as to explore the associations between Hb levels and clinical outcomes.

Objectives: To study the proportion of anaemia in patients with chronic obstructive pulmonary disease attending a tertiary health care centre in Kerala

Methods: This was a cross-sectional study done among 120  patients  with  COPD. Samples  were selected by  consecutive  sampling  method, data  collected using  a  proforma and it  was analyzed  using  SPSS.

Results: In this study, 120 COPD patients diagnosed based on GOLD clinical criteria were recruited. 53 patients were in anemic group while 67 patients in nonanemic group. The prevalence of anemia in COPD patients in the present study was 44.2%. The mean hemoglobin levels in anemic group were 10.87 ±1.73g/dl, whereas in nonanemic group, it was 14.57 ± 1.6 g/dl. It was found that the most common morphological type of anaemia was normocytic normochromic (49.1%) followed by microcytichypochromic (37.7%).

Conclusion: Presence of anaemia is significantly associated with worse hospital outcome in the form of increased ICU admission, increased requirement of NIV and mechanical ventilation and increased mortality.

Keywords: COPD, anaemia, haemoglobin, mortality, exacerbation.

References

  1. Kent BD, Mitchell PD, Mcnicholas WT. Hypoxemia in patients with COPD: Cause, effects, and disease progression. International Journal of COPD. 2011.
  2. Chambellan A, Chailleux E, Similowski T. Prognostic value of the hematocrit in patients with severe COPD receiving long-term oxygen therapy. Chest. 2005
  3. John M, Hoernig S, Doehner W, Okonko DD, Witt C, Anker SD. Anemia and inflammation in COPD. Chest. 2005;
  4. Similowski T, Agustí A, MacNee W, Schönhofer B. The potential impact of anaemia of chronic disease in COPD. European Respiratory Journal. 2006.
  5. Who, Chan M. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva, Switz World Heal Organ. 2011;
  6. Ittyachen A, Krishnamoorthy S, Bhatt A, Abdulla S, Roy J, Sugathan M, et al. Predictors of outcome in patients admitted with acute exacerbation of chronic obstructive pulmonary disease in a rural Tertiary Care Center. J Fam Med Prim Care. 2016;
  7. Parveen S, Rangreze I, Ahmad SN, Mufti SA, Khan SS. Prevalence of Anemia in Patients with COPD and Its Potential Impact on Morbidity of COPD Patients. Int J Clin Med. 2014;
  8. Pandey S, Garg R, Kant S, Gaur P. Chronic Obstructive Pulmonary Disease with Anemia as Comorbidity in North Indian Population. Adv Biomed Res. 2018;
  9. 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;

Corresponding Author

Dr H Poornima

Professor, Department of Medicine, Govt.TD Medical College, Alappuzha, Kerala, India