The Negative Prognostic Synergism of Anemia and Heart Disease in Female Nursing Home Residents

Maria, Renata De; Ripamonti, Vittorino; Sandri, R; Ceretti, Aldo Pisani; Ferratini, Maurizio

doi:10.1016/j.amjcard.2005.06.095

Cited by 18 publications

(21 citation statements)

References 15 publications

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“…The overall anemia prevalence in this study was about the same, or lower, especially among women, compared to other earlier studies in nursing homes [17–23]. …”

Section: Discussionsupporting

confidence: 53%

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Prevalence and predictive importance of anemia in Swedish nursing home residents – a longitudinal study

et al. 2016

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BackgroundAnemia is common in elderly people and especially in nursing home residents. Few studies have been performed on the consequences of anemia in a nursing home population. This study explored the prevalence of anemia in nursing homes in Sweden, including risk factors and mortality associated with anemia or hemoglobin (Hb) decline.MethodsThree hundred ninety patients from 12 nursing homes were included during 2008–2011. Information about medication, blood samples, questionnaire responses and information about physical and social activities was recorded. The baseline characteristics of the patients were compared for subjects with and without anemia. Vital status was ascertained during the following 7 years from baseline to compare the survival. Hb levels <120 g/L in women and <130 g/L in men were used to define anemia. For 220 of the subjects Hb change during one year was registered and the quartiles in Hb change were compared in terms of baseline characteristics and mortality.ResultsThe prevalence of anemia at baseline was 52% among men and 32% among women. The men with anemia had a two-year mortality significantly higher (61%) than the men without anemia (29%, p = 0.001) but there was no statistical difference in two-year survival in women. In anemic men there was a higher mortality (Hazard Ratio = 1.58) during a total follow-up period of up to 7 years after adjustment for age, increased B-type natriuretic peptide (BNP) and decreased estimated Glomerular Filtration Rate (eGFR). Among men, but not women, we found baseline correlations between anemia and elevated BNP (>100 ng/L) and severely reduced eGFR (<30 ml/min). When the lowest quartile of Hb change (decline > 9 g/L) was compared with the highest (improvement > 6 g/L) the mortality was higher in the lowest quartile (p = 0.03).ConclusionsAnemia is common in nursing home residents in Sweden, especially among men for whom it is related to higher mortality. A rapid Hb drop is associated with higher mortality. Regardless of earlier Hb values, monitoring Hb regularly in a nursing home population seems important for catching rapid Hb decline correlated with higher mortality.

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“…The overall anemia prevalence in this study was about the same, or lower, especially among women, compared to other earlier studies in nursing homes [17–23]. …”

Section: Discussionsupporting

confidence: 53%

“…Among women in nursing homes the occurrence varies between 49 and 65% [17, 19, 20, 22, 23] and among men between 45 and 70% [17, 19, 20, 22]. …”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictive importance of anemia in Swedish nursing home residents – a longitudinal study

et al. 2016

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“…Several studies have demonstrated significantly increased mortality with decreased Hb levels, particularly among patients with CKD, congestive heart failure, diabetes and HIV infection [12][13][14][15][16] . In residents of a long-term care facility, Kiely et al 16 found a 1.98 greater risk of mortality in anemic women (where anemia was identified from a diagnosis listed in the patient's Minimal Data Set).…”

Section: Objectivementioning

confidence: 99%

Study of anemia in long-term care (SALT): prevalence of anemia and its relationship with the risk of falls in nursing home residents

Pandya

Bookhart

Mody

et al. 2008

Current Medical Research and Opinion

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Anemia in nursing home residents appears to be under-recognized. For residents over 70 years, the prevalence of anemia in both male and female residents was approximately four times the rate reported in a study of older community dwellers (Salive et al., 1992). Both anemia and the use of psychoactive medications are potentially modifiable factors strongly associated with falling. Since falls and related fractures are events associated with high morbidity and mortality, each of these factors deserves special consideration for potentially reducing the risk of such events in the nursing home.

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“…Using World Health Organization (WHO)1 criteria to define anemia (<12 g/dL for nonpregnant females and <13 g/dL for adult males), rates of anemia in the United States (US) were found to be 40%2 in one nursing home, 48%3 in five nursing homes, 56%4 across 40 nursing homes, and 60% in one nursing home chain 5. In Italy, De Maria et al6 reported an anemia prevalence rate of 50% in a chart review of 441 female nursing home residents.…”

Section: Introductionmentioning

confidence: 99%

Falls in nursing home residents receiving pharmacotherapy for anemia

Reardon

Pandya²,

Bailey³

2012

CIA

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PurposeFalls are common among nursing home residents and have potentially severe consequences, including fracture and other trauma. Recent evidence suggests anemia may be independently related to these falls. This study explores the relationship between the use of anemia-related pharmacotherapies and falls among nursing home residents.MethodsForty nursing homes in the United States provided data for analysis. All incidents of falls over the 6-month post-index follow-up period were used to identify the outcomes of falls (≥1 fall) and recurrent falls (>1 fall). Logistic regression was used to analyze the relationship between falls and recurrent falls with each of the anemia pharmacotherapies after adjusting for potential confounders.ResultsA total of 632 residents were eligible for analysis. More than half (57%) of residents were identified as anemic (hemoglobin < 12 g/dL females, or <13 g/dL males). Of anemic residents, 50% had been treated with one or more therapies (14% used vitamin B12, 10% folic acid, 38% iron, 0.3% darbepoetin alfa [DARB], and 1.3% epoetin alfa [EPO]). Rates of falls/ recurrent falls were 33%/18% for those receiving vitamin B12, 40%/16% for folic acid, 27%/14% for iron, 38%/8% for DARB, 18%/2% for EPO, and 22%/11% for those receiving no therapy. In the adjusted models, use of EPO or DARB was associated with significantly lower odds of recurrent falls (odds ratio = 0.06; P = 0.001). Other significant covariates included psychoactive medication use, age 75–84 years, age 85+ years, worsened balance score, and chronic kidney disease (P < 0.05 for all).ConclusionOnly half of the anemic residents were found to be using anemia therapy (vitamin B12, folic acid, or iron). There is little evidence to support an association between the use of vitamin B12, folic acid, or iron in reducing the rates of falls and recurrent falls in nursing homes. Reduced odds of recurrent falls were observed for DARB or EPO users.

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The Negative Prognostic Synergism of Anemia and Heart Disease in Female Nursing Home Residents

Cited by 18 publications

References 15 publications

Prevalence and predictive importance of anemia in Swedish nursing home residents – a longitudinal study

Prevalence and predictive importance of anemia in Swedish nursing home residents – a longitudinal study

Study of anemia in long-term care (SALT): prevalence of anemia and its relationship with the risk of falls in nursing home residents

Falls in nursing home residents receiving pharmacotherapy for anemia

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