Abstract 11821: Association of Hemoglobin With Mortality Outcomes in the Critical Care Cardiology Trials Network (CCCTN) Registry

Abstract

Introduction: Anemia is common in critically ill patients and is a known risk indicator for poor outcomes. Little is known about the impact of anemia on short term outcomes in the setting of cardiac critical illness. We examined the association of varying degrees of anemia with in-hospital outcomes in cardiac intensive care unit (CICU) admissions. Methods: The Critical Care Cardiology Trials Network (CCCTN) is a multicenter network of tertiary CICUs in North America coordinated by the TIMI Study Group. During annual campaigns, each center contributes at least 2-mo of all consecutive medical CICU admissions. Admissions were stratified according to baseline hemoglobin (Hgb). The association of Hgb and in-hospital mortality, CICU length of stay and hospital length of stay was examined by logistic regression with multivariable adjustment. Results: Among 17,759 admissions, the median baseline Hgb was 12.0 g/dL (IQR 10.0, 13.8). Patients with lower Hgb tended to be older and female with lower body weight and a greater burden of comorbidities. After adjusting for sex and other relevant covariates, a lower baseline Hgb was associated with higher odds of in-hospital death (p-trend <0.0001), and longer CICU and hospital length of stay (p-trend <0.0001). Conclusions: Anemia is prevalent in half of patients admitted to the CICU. Lower Hgb level, even well above standard transfusion thresholds, is independently associated with higher in-hospital mortality and longer length of stay in cardiac critical illness.