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Impact of anemia on functional state of patients with chronic obstructive pulmonary disease

Alexandru Corlateanu1, Gloria Montanari2, Serghei Pylchenko1, Victor Botnaru1, Victoria Sircu1

1Department of Respiratory Medicine, State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Moldova, 2Department of Respiratory Diseases, Department of  Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, Modena, Italy

Abstract

Background: The occurrence and prevalence of anemia in patients with chronic obstructive pulmonary disease (COPD) has been little studied. Recent studies prove that anemia in patients with COPD is highly prevalent and associated with increased mortality. Anemia is such a common and simple clinical finding that its real physiologic relevance in COPD can be frequently underestimated.

The aim of this study was to determine the prevalence of anemia in patients with COPD and to analyse the associations between hemoglobin levels and some clinical outcomes.

Methods: 158 consecutive patients with COPD were recruited into the study. Spirometry (FEV1, FVC, FEV1/FVC), hemoglobin levels, dyspnoea by MRC scale, exercise capacity by 6-minute walking distance (6MWD) test, the BODE index were evaluated. The comorbidities were assessed by Charlson Comorbidity Index (CCI).

Results: All patients were distributed according to the age in 2 groups: 80 elderly patients, mean age 72.2 ± 4.82 years and 78 younger patients, average age 56.8±3.94 years. Patients had the similar degree of bronchial obstruction, measured by FEV1,%: 42.3±12.82% versus 42.7±14.44% (p>0.05). Anemia was present in 25 (31%) elderly patients and in 22 (28%) young patients with COPD. Older patients with anemia had more comorbidities and higher BODE than nonanemic persons (CCI 3.16±1.18 versus 2.76 ±1.37, p<0.05 and BODE 7.3±1.5 versus 6.8±1.84, p<0,05). Mean MRC values were significantly higher (4.04±0.74 versus 3.73±0.59, p<0.05) and mean 6MWD was significantly shorter (181±69 m versus 221±85 m, p<0.05) in anemic in comparison with nonanemic elderly patients. The forward stepwise regression analysis shows that the level of hemoglobin is an important predictor of dyspnoea and an exercise capacity in elderly COPD patients which explains 21% of the MRC scale and 17% of the exercise capacity.

Conclusion: Anemia in COPD is an independent risk factor for worsening of dyspnoea and reducing functional capacity.

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Alexandros G. Mathioudakis MD1, Victoria Chatzimavridou-Grigoriadou MS1, Aggelos S. Aggelakas MD1, Georgios A. Mathioudakis MD, PhD2.
1 Respiratory Assembly, Hellenic Society for the Advancement of Biomedical Research2 Respiratory Department, IASO General Hospital, Athens, Greece

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Georgios Tsaknis MD, PhD
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Aggelos S. Aggelakas, MD
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Alexandros G. Mathioudakis MD1, Efstathia I. Evangelopoulou MD2, Georgios A. Mathioudakis MD2
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Alexandros G. Mathioudakis MD1, Victoria Chatzimavridou-Grigoriadou MS2, Georgios A. Mathioudakis MD, PhD2.
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Alexandros G. Mathioudakis MD1, Efstathia I. Evangelopoulou MD2.
1Medical Department, Southport and Ormskirk NHS Trust, UK. 2 Respiratory Department, General Hospital of Nikaia St. Panteleimon, Greece.
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