Potentially modifiable predictors of mortality in patients treated with long-term oxygen therapy
MetadataShow full item record
Introduction: Anemia is considered a systemic manifestation of Chronic Obstructive Pulmonary Disease (COPD); however, few studies have described its influence on chronic respiratory failure (CRF) prognosis. We aimed to test the hypotheses that anemia negatively influences survival and also to identify the cut-off points of hematocrit (Htc) and hemoglobin (Hb) associated with higher mortality in CRF patients using long-term oxygen therapy (LTOT). Methods: One-hundred forty two patients with CRF in use of LTOT were evaluated at baseline and followed for three years or until death. Baseline assessment included identification, diagnosis, body composition, dyspnea, health status (HS), spirometry, arterial blood gases, Hb and Htc. Univariate and Cox proportional hazard models were used to evaluate predictors of mortality. We performed ROC curve to identify the best cut-off point of the variables related to survival to construct the Kaplan-Meier curves.Results: Eight-three patients (58%) died after three years. Baseline values of Hb and Htc were significantly lower in the non-survivors group and both, Htc (HR, 0.96; 95%Cl 0.91-0.99; p = 0.04), Hb (HR, 0.86; 95%Cl 0.76-0.98; p = 0.02) were selected as predictors of mortality after three years. The cut-off points determined were: the value of HB is < 11g/dl (sensitivity 95% specificity 85%), Htc <= 33% (sensitivity 97% specificity 89%). Other prognostic factors were: male gender, low PaCO2 and SpO(2), higher dyspnea perception and impairment of HS.Conclusions: Our study shows that anemia is a predictor of mortality in patients with CRF under LTOT treatment. Although anemia is potentially modifiable, the effects of raising hemoglobin on mortality remain undetermined. (C) 2010 Elsevier Ltd. All rights reserved.
How to cite this document
Showing items related by title, author, creator and subject.
Pinho, Sheila Zambello de ; Oliveira, José Brás Barreto de ; Gazola, Rodrigo José Cristiano ; Mazotti, Adriano César ; Molero, Camila Schimite ; Mendes, Carolina Borghi ; Mello, Denise Fernandes de ; Marques, Emilia de Mendonça Rosa ; Talamoni, Jandira Liria Biscalquini ; Silva, José Humberto Dias da et al. (Coleção PROGRAD (UNESP), 2011) [Livro]
Pinho, Sheila Zambello de ; Oliveira, José Brás Barreto de ; Pontes, Sueli Rodrigues ; Almeida, Djanira Soares de Oliveira e ; Godoy, Kathya Maria Ayres de ; Rosa, Claudia de Souza ; Nunes, Julianus Araújo ; Salvador, Sérgio Azevedo ; David, Célia Maria ; Vilche Peña, Angel Fidel et al. (Coleção PROGRAD (UNESP), 2011) [Livro]
Pinho, Sheila Zambello de ; Spazziani, Maria de Lourdes ; Mendonça, Sueli Guadelupe de Lima ; Rubo, Elisabete Aparecida Andrello ; Villarreal, Dalva Maria de Oliveira ; Duarte, Camila ; Okamoto, Mary Yoko ; Souza, Thais R. ; Garms, Gilza Maria Zauhy ; Marin, Fátima Aparecida Dias Gomes et al. (Coleção PROGRAD (UNESP), 2012) [Livro]