Anemia as Predictor of In-Hospital Mortality Among Patients Having Congestive Heart Failure

Abstract

Background: Anemia remains an important risk factor which contributes towards the worsening of the outcomes, consisting of cardio-renal anemia syndrome and its impact in heart failure remains to be complex and multifactorial. The current study was done to evaluate the role of anemia on mortality among patients having congestive heart failure. Material and methods: This study included a total of 115 patients with congestive heart failure presenting at Chaudhry Pervez Elahi Institute of Cardiology (CPEIC) Multan. After the inclusion of patients in study, 3 ml of venous blood sample was drawn under aseptic conditions and immediately transported to the hospital laboratory in EDTA vial for hemoglobin levels analysis. These patients were followed till discharge to document in-hospital mortality during current hospitalization. All the sociodemographic distribution and other relevant information such as age, gender, area of residence, diabetes, hypertension,  obesity, smoking, hyperlipidemia and mortality were noted in the proforma and data was entered and analyzed by SPSS version 22 for descriptive statistics and tests of significance. Anemia was cross-tabulated against in-hospital mortality using two by two table and chi-square test was applied at level of significance of 0.05. Results: Among our 115 patients with congestive heart failure, 75 (65.2%) were males and 40 (34.8%) were females. Mean age of our patients with CHF was 57.17 ± 11.65 years ranging from 34 to 80 years. Although males were younger than female patients with congestive heart failure but this difference was not statistically significant (p=0.140). Seventy five (65.2%) were from rural areas, 40 (34.8%) were poor, 70 (60.9%) from middle income families and only 5 (4.3%) belonged to rich families. Forty five (39.1%) had diabetes and 55 (47.8%) had hypertension. Mean body mass index (BMI) of patients with congestive heart failure was 26.12 ± 2.93 kg/m² and 35 (30.4%) were obese. Twenty five (21.7%) were smokers. Mean hemoglobin level of these patients was 11.36 ± 2.55 d/dl ranging from 6.6 to 14.7 g/dl and anemia was documented in 60 (52.2%) our patients. In-hospital mortality in patients with congestive heart failure was 12 (10.4%) and of these 12 mortalities, severe anemia was noted in 7 (58.33%) patients. Conclusion: Our study results have documented high frequency of anemia among patients with congestive heart failure. In-hospital mortality was significantly associated with anemia and its severity. Hemoglobin levels were significantly less among patients with in-hospital mortality compared with those who were alive. Our study results suggest early diagnosis anemia followed by timely management can help to decrease adverse events among patients with congestive heart failure.

Keywords: Congestive Heart Failure, anemia, in-hospital mortality.