Prevalence and impact of anemia in patients with chronic respiratory diseases

Abstract

Objective This study aimed to evaluate the prevalence and type of anemia in patients with different chronic pulmonary diseases and its impact on the quality of life. Patients and methods The current study is a prospective observational study that was conducted at Chest Department, Minia University Hospital during the period from November 2015 to January 2017. A total of 247 patients with chronic pulmonary diseases (97 chronic obstructive pulmonary disease, 45 idiopathic pulmonary fibrosis, 80 bronchial asthma, 25 bronchiectasis) were included in our study. For all included patients the following were done,full history taking, assessment of the grade of dyspnea using modified medical research council dyspnea scale, assessment of BMI, chest ꞉ X ray (CXR), ECG and when indicated echocardiography, pulmonary functions tests, routine laboratory investigations, including complete blood count, liver function test, renal function test, serum electrolytes, erythrocyte sedimentation rate, C-reactive protein, measurement of arterial blood gases, measurements of serum erythropoietin, iron and total iron binding capacity, St George’s Respiratory Questionnaire was used for all patients to assess the health-related quality of life. Results Anemia occurs in 36.4% of all patients. It occurs in 46.4% of chronic obstructive pulmonary disease patients, 37.8% of idiopathic pulmonary fibrosis patients, and 12.5% of patients with asthma and in 68% of patients with bronchiectasis. Normocytic normochromic anemia was the predominant type of anemia in the studied patients. There was a significant difference between anemic patients and patients with normal hemoglobin (Hb) with respect to smoking index, comorbidities, forced expiratory volume 1, forced vital capacity, and PO2. C-reactive protein and erythrocyte sedimentation rate were significantly higher in the anemic group. Serum iron and total iron binding capacity were significantly lower in the anemic patients, whereas erythropoietin was significantly lower in patients with normal Hb. Anemic patients had significantly higher medical research council dyspnea scale and number of exacerbation than patients with normal Hb. Anemic patients had significantly higher score in all the components of St George’s Respiratory Questionnaire. Conclusion Anemia is commonly associated with comorbidity in patients with chronic pulmonary diseases. The presence of anemia has a negative impact on the patient’s quality of life. Anemia was significantly associated with; the severity of impairment of lung functions, level of systemic inflammatory markers, presence of other comorbidities, and the smoking index. It was also associated with increased severity of dyspnea and frequent exacerbations.