BACKGROUND: Although traditionally associated with polycythemia, COPD has a systemic inflammatory component that could interfere with erythropoiesis. This study describes the distribution and prognostic value of the hematocrit in patients with severe COPD receiving long-term oxygen therapy (LTOT). METHODS: A total of 2,524 patients with COPD, FEV1/vital capacity (VC) < 70%, FEV1 < 80% of predicted, and Pa(O2) < 7.3 kPa in whom a hematocrit was available at entry was identified between 1980 and 1999 in the French Association Nationale pour le Traitement à Domicile de l'Insuffisance Respiratoire chronic respiratory insufficiency and home-care database (male/female ratio, 5/1; mean +/- SD age, 68 +/- 10 years for men, and 70 +/- 10 years for women). Correlations between hematocrit, demographic data, and pulmonary function data were examined. A multivariate Cox proportional hazard regression was performed to identify prognostic factors. RESULTS: Mean hematocrit was 45.9 +/- 7.0% in men and 43.9 +/- 6.0% in women (< 39% in 12.6% of men, and < 36% in 8.2% of women) according to the World Health Organization definition of anemia. Hematocrit was negatively correlated with age (r = - 0.245) and FEV1/VC (r = - 0.068) and was positively correlated with Pa(CO2) (r = 0.161) and body mass index (r = 0.127). Multivariate analysis found hematocrit to be an independent predictor of survival, hospital admission rate, and cumulative duration of hospitalization. The 3-year survival was 24% (95% confidence interval, 16 to 33%) when the hematocrit was < 35%, and 70% (63 to 76%) when the hematocrit was > or = 55%. CONCLUSIONS: A low hematocrit is not uncommon in LTOT/COPD patients. Hematocrit is negatively associated with mortality and morbidity. Whether the association is causative or not and whether or not corrective measures are warranted remain to be determined.
BACKGROUND: Although traditionally associated with polycythemia, COPD has a systemic inflammatory component that could interfere with erythropoiesis. This study describes the distribution and prognostic value of the hematocrit in patients with severe COPD receiving long-term oxygen therapy (LTOT). METHODS: A total of 2,524 patients with COPD, FEV1/vital capacity (VC) < 70%, FEV1 < 80% of predicted, and Pa(O2) < 7.3 kPa in whom a hematocrit was available at entry was identified between 1980 and 1999 in the French Association Nationale pour le Traitement à Domicile de l'Insuffisance Respiratoire chronic respiratory insufficiency and home-care database (male/female ratio, 5/1; mean +/- SD age, 68 +/- 10 years for men, and 70 +/- 10 years for women). Correlations between hematocrit, demographic data, and pulmonary function data were examined. A multivariate Cox proportional hazard regression was performed to identify prognostic factors. RESULTS: Mean hematocrit was 45.9 +/- 7.0% in men and 43.9 +/- 6.0% in women (< 39% in 12.6% of men, and < 36% in 8.2% of women) according to the World Health Organization definition of anemia. Hematocrit was negatively correlated with age (r = - 0.245) and FEV1/VC (r = - 0.068) and was positively correlated with Pa(CO2) (r = 0.161) and body mass index (r = 0.127). Multivariate analysis found hematocrit to be an independent predictor of survival, hospital admission rate, and cumulative duration of hospitalization. The 3-year survival was 24% (95% confidence interval, 16 to 33%) when the hematocrit was < 35%, and 70% (63 to 76%) when the hematocrit was > or = 55%. CONCLUSIONS: A low hematocrit is not uncommon in LTOT/COPDpatients. Hematocrit is negatively associated with mortality and morbidity. Whether the association is causative or not and whether or not corrective measures are warranted remain to be determined.
Authors: Shailaja J Hayden; Tyler J Albert; Timothy R Watkins; Erik R Swenson Journal: Am J Respir Crit Care Med Date: 2012-01-26 Impact factor: 21.405
Authors: Sarah J Hemauer; Adam J Kingeter; Xue Han; Matthew S Shotwell; Pratik P Pandharipande; Liza M Weavind Journal: Crit Care Med Date: 2017-05 Impact factor: 7.598
Authors: Dheeraj Gupta; Ritesh Agarwal; Ashutosh Nath Aggarwal; V N Maturu; Sahajal Dhooria; K T Prasad; Inderpaul S Sehgal; Lakshmikant B Yenge; Aditya Jindal; Navneet Singh; A G Ghoshal; G C Khilnani; J K Samaria; S N Gaur; D Behera Journal: Lung India Date: 2013-07