Hemoglobin and mortality in patients with COPD: a nationwide population-based cohort study
Received 7 December 2017
Accepted for publication 27 March 2018
Published 16 May 2018 Volume 2018:13 Pages 1599—1605
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 4
Editor who approved publication: Dr Richard Russell
Seon Cheol Park,1,2 Young Sam Kim,3 Young Ae Kang,3 Eun Cheol Park,4 Cheung Soo Shin,5 Dong Wook Kim,6 Chin Kook Rhee7
1Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea; 2Department of Medicine, Yonsei University College of Medicine, Seoul, Korea; 3Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; 4Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea; 5Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea; 6Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea; 7Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Purpose: Previous studies have reported that anemia increased mortality in patients with COPD. However, it is unclear whether anemia is associated with increased COPD mortality in the general population. The purpose of our study is to identify whether anemia is related to long-term mortality in COPD using a large population-based database.
Patients and methods: Using the National Health Insurance Service-Health Screening Cohort, we identified COPD patients with available hemoglobin level. We analyzed mortality among patients with COPD from 2003 to 2013 according to hemoglobin level.
Results: A total of 7,114 patients with COPD were identified. Mean age was 65.0±9.3 years, and 62.9% were male. Anemia was present in 469 patients (6.6%). The overall mortality rate was 46.5% in anemia and 32.1% in non-anemia groups (p<0.001). The hazard ratio of anemia for mortality was 1.31 (95% CI, 1.11–1.54). Among patients with anemia, the hemoglobin level correlated well with mortality.
Conclusion: Anemia was associated with increased long-term mortality of COPD, and even mild anemia was related to a significantly increased risk.
Keywords: COPD, mortality, anemia, hemoglobin
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