[Anemia in hospitalized patients with cirrhosis: prevalence, clinical relevance and predictive factors]

Abstract

Background: few studies have examined the anemia in hospitalized cirrhotic patients.

Objective: to assess the prevalence, predictive factors and prognosis for mortality of anemia in admitted cirrhotic patients.

Patients and methods: descriptive study of cases and controls; 178 hospitalization of 114 patients were reviewed (mean age 52.4 years; 106 alcoholics) between May/2004 and June/2007. Those with acute losses of blood were excluded. The anemia was classified as slight, moderate, and severe, since a hemoglobin < 12 g/dl. There were considered as cases the admissions in which the hemoglobin had < 10 g/dl (moderate and severe anemia).

Results: a diagnosis of anemia was made in 155 admissions, 47% were moderate and 19% severe. Hospital mortality rate in cases was 19.6%, and in controls 5.3%, [OR 4.39 (p = 0.004)]. The independent predictive factors for mortality were: score of Child-Pügh [OR 1.99 (p = 0.0005)], creatinine > 1.5 mg/dl [OR 11.34 (p = 0.0006)] and infections [OR 5.78 (p = 0.018)]. The cases had a greater risk of renal insufficiency [27.5% vs. 3.9%, OR 9.2 (p = 0.0001)]. Classification of Child-Pügh, total bilirubin > 10 mg/dl, albumin < 2.5 g/dl, infections, hepatic encephalopathy and alcoholic hepatitis also were predictive factors of moderate-severe anemia. The independent predictive factors for moderate-severe anemia were score ofChild-Piigh and renal insufficiency.

Conclusion: the anemia had a high prevalence with an increase of hospital mortality rate, although it was not an independent risk factor for death. The renal insufficiency and the severity of the hepatic disease were associated in independent form with moderate-severe anemia in patients admitted with cirrhosis.