Abstract
BackgroundSeveral studies investigated the association of anemia with health related quality of life (HRQL) in patients with chronic disease. However, there is little evidence regarding the association of anemia with HRQL in patients with chronic obstructive pulmonary disease (COPD).MethodsThis is a post-hoc analysis of a study which enrolled a population of adults aged 35–79 randomly selected from residents of Erie and Niagara Counties, NY, between 1996 and 2000. In addition to demographic information and physical measurements, we obtained spirometry data and hemoglobin levels. We used modified Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria to define COPD, and World Health Organization (WHO) criteria to define anemia. To assess HRQL we used the Short Form-36 (SF-36) to assess physical functioning (PF), physical component summary (PCS) measures and mental component summary (MCS) measures.ResultsIn the entire study population (n = 2704), respondents with anemia had lower scores on the physical functioning domain [45.4 (SD10.9) vs. 49.2 (SD 9.1); p < 0.0001]. Among patients with COPD (n = 495) the PF scores (39.9 vs. 45.4) and the PCS (41.9 vs. 45.9) were significantly lower in individuals with anemia compared to those without. In multiple regression analysis, the association between hemoglobin and PCS was positive (regression coefficient 0.02, p = 0.003). There was no significant association of hemoglobin with PF scores or the mental component summary measure after adjusting for covariates in patients with COPD.ConclusionIn patients with moderate to very severe COPD anemia may be associated with worse HRQL. However, co-morbidities may explain part or all of this association in these patients.
Highlights
Several studies investigated the association of anemia with health related quality of life (HRQL) in patients with chronic disease
The mean physical functioning score and the physical component summary (PCS) were significantly lower in participants with anemia
When we examined the data after stratifying by gender we found that the physical functioning (PF) and PCS scores are significantly different between the two groups only for females (36.3 vs. 44.6 for PF and 39.2 vs. 45.5 for PCS)
Summary
Several studies investigated the association of anemia with health related quality of life (HRQL) in patients with chronic disease. Health related quality of life (HRQL) is an important clinical outcome for patients with advanced lung disease and their health care providers [1]. This outcome measure helps differentiate between individuals with varying severity of lung disease and allows to evaluate how much impact a specific intervention has on patients' lives. Fatigue is a frequent symptom in patients with chronic obstructive pulmonary disease (COPD). Fatigue is the primary symptom of anemia [3]. Dyspnea is another manifestation of anemia because of reduced oxygen carrying capacity of the blood. Anemia is one of the most treatable cause of fatigue in general [4]
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