• UABDivulga
12/2007

COPD and anemia: an underdiagnosed association

Glòbuls vermells
Chronic Obstructive Pulmonary Disease (COPD) is a highly prevalent disease in Spain.  It is the fourth cause of death in developed countries and overall fifth in the world according to World Health Organization estimates. A study with patients suffering from COPD shows that the anemia associated with this disease goes undiagnosed in most of the cases.

Chronic Obstructive Pulmonary Disease (COPD) is a highly prevalent disease in Spain that is characterized by the presence of a chronic and partially reversible flow obstruction of air basically caused by an abnormal inflammatory response to tobacco smoke. COPD is the fourth cause of death in developed countries and overall fifth in the world according to World Health Organization estimates.

Anemia, as an associated co-morbidity, has proven to be an independent marker of mortality in several pathologies such as cardiovascular, renal and oncological diseases. This association can also negatively influence several functional parameters and the patient's quality of life. However, there is limited information in the current literature describing the distribution of haemoglobin (Hb) and its impact on outcomes in the COPD. The objective of the study was to determine the prevalence of anemia in individuals diagnosed with COPD in a tertiary hospital over one year. An elevated number of patients presented anemia; of 177 cases, 56 (31%) had anemia. The most frequent was inflammatory anemia (anemia of chronic disease). Very few analyses were requested to determine the cause of this anemia, which suggests that this disease was undiagnosed.

What is highlighted in this study was the elevated number of patients with anemia who received long term oxygen therapy. It has been shown that oxygen therapy influences hemoglobin levels. Given that this is a subgroup of patients is found in the worst functional class, it could be speculated that the presence of anemia would considerably alter their quality of life, due to compromises in oxygen delivery to tissue despite the adequate management of their oxygen therapy.

The main conclusion of this study is that anemia is frequently present in patients with COPD. We consider that whatever the type of anemia, an exhaustive diagnosis and treatment is necessary. However, before planning treatment, it is necessary to adequately evaluate its true prevalence, causes and factors that predispose the patient to this disease. For this reason, it is necessary to carry out studies that analyze the relationship between these two conditions.

Karina Portillo

Universitat Autònoma de Barcelona

Hospital de la Santa Creu i de Sant Pau,Departamento de Pneumología.

References

"High frequency of anemia in COPD patients admitted in a tertiary hospital" (Spanish)Portillo K, Belda J, Antón P, Casan P. Revista Clínica Española. 2007 Sep;207(8):383-7

 
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