Prevalence of anemia and its influence on hospital readmissions and emergency department visits in outpatients with heart failure

Eur J Cardiovasc Nurs. 2017 Dec;16(8):687-695. doi: 10.1177/1474515117710154. Epub 2017 May 12.

Abstract

Background: Anemia is a frequent comorbidity in patients with heart failure. However, the incidence of anemia in patients with heart failure varies widely, and there is limited evidence on the association between anemia and rehospitalization and on the health consequences of anemia in patients with heart failure.

Aims: We aimed to identify the prevalence of anemia and its influence on hospital readmissions and emergency department visits in outpatients with heart failure.

Methods: This cross-sectional study included 284 patients with heart failure diagnosed at outpatient cardiology clinics at a tertiary care university hospital in Cheonan, South Korea. We obtained socio-demographic and clinical information, including frequency of readmissions and emergency department visits, using face-to-face interviews and medical record reviews.

Results: The prevalence of anemia, defined based on World Health Organization guidelines, was 39.1% among patients with heart failure. Anemia was significantly more prevalent among patients with one or more re-admissions or emergency department visits compared with patients with no history of hospital re-admissions or emergency department visits (42.7% vs. 13.9% ( p = 0.001) and 55.1% vs. 34% ( p = 0.002) respectively). Anemia increased the risk of hospital readmission (odds ratio =8.04, 95% confidence interval, 2.19-29.54) and emergency department visit (odds ratio=2.37, 95% confidence interval, 1.22-4.60) in patients with heart failure.

Conclusion: It is imperative that patients with heart failure presenting with anemia undergo appropriate nursing assessment and intervention. Future prospective studies targeting interventions to improve anemia are required to determine whether anemia influences readmission rates and emergency department visits.

Keywords: Anemia; emergency department; heart failure; hospital readmission; prevalence.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anemia / epidemiology
  • Anemia / etiology*
  • Comorbidity*
  • Cross-Sectional Studies
  • Emergency Service, Hospital / standards*
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Heart Failure / complications*
  • Heart Failure / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Outpatients / statistics & numerical data*
  • Patient Readmission / standards*
  • Patient Readmission / statistics & numerical data*
  • Prevalence
  • Prospective Studies
  • Republic of Korea / epidemiology
  • Socioeconomic Factors