High hemoglobin is associated with increased in-hospital death in patients with chronic obstructive pulmonary disease and chronic kidney disease: a retrospective multicenter population-based study
Abstract Background Chronic kidney disease (CKD) is a common comorbidity of chronic obstructive pulmonary disease (COPD). Although high hemoglobin (Hb) is detrimental to CKD patients, its relationship with poor outcomes in the COPD population has not been reported. This study aimed to investigate th...
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doaj-ee5d28f99f9b403eba517d5cbfe57a6d2020-11-25T03:42:21ZengBMCBMC Pulmonary Medicine1471-24662019-09-011911810.1186/s12890-019-0933-4High hemoglobin is associated with increased in-hospital death in patients with chronic obstructive pulmonary disease and chronic kidney disease: a retrospective multicenter population-based studyLibin Xu0Yuanhan Chen1Zhen Xie2Qiang He3Shixin Chen4Wenji Wang5Guohui Liu6Yuanjiang Liao7Chen Lu8Li Hao9Jin Sun10Wei Shi11Xinling Liang12on behalf of China collaborative study on AKI (CCS-AKI)The Second School of Clinical Medicine, Southern Medical UniversityDivision of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Dermatology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s HospitalDepartment of Nephrology, Zhejiang Provincial People’s Hospital (People’s Hospital of Hangzhou Medical College)Division of Preventive Medicine, School of Public Health, Guangzhou Medical UniversityDivision of Nephrology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong UniversityDepartment of Nephrology, Dongguan People’s HospitalDepartment of Nephrology, Chongqing Ninth People’s HospitalDepartment of Nephrology, People’s Hospital of Xinjiang Uygur Autonomous RegionDepartment of Nephrology, Second Hospital of Anhui Medical UniversityDepartment of Nephrology, Second Hospital of Jilin UniversityThe Second School of Clinical Medicine, Southern Medical UniversityDivision of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesAbstract Background Chronic kidney disease (CKD) is a common comorbidity of chronic obstructive pulmonary disease (COPD). Although high hemoglobin (Hb) is detrimental to CKD patients, its relationship with poor outcomes in the COPD population has not been reported. This study aimed to investigate the relationship between high Hb and in-hospital mortality and to explore reference Hb intervals in patients with COPD and CKD. Methods This retrospective study was multicenter population-based. A total of 47,209 patients who presented with COPD between January 2012 and December 2016 were included. The average Hb level during hospitalization was used as the Hb level. CKD and advanced CKD were defined as estimated glomerular filtration rates < 60 and < 30 ml/min/1.73 m2, respectively. The association between Hb level (measured in 1 g/dL intervals) and in-hospital mortality was analyzed in different multivariable logistic regression models by CKD stratification. Results The Hb level was decreased in the CKD subgroup. In the non-CKD group, a higher Hb level was not associated with an increased risk of in-hospital death. However, the Hb level and mortality showed a U-shaped relationship in the CKD group. After adjusting for age and Charlson Comorbidity Index, multivariable regression analysis showed that an Hb level > 17 g/dL was associated with an increased risk of death in the CKD group with an odds ratio (OR) of 2.085 (95% CI, 1.019–4.264). Hb > 14 g/dL was related to an increased risk of death in advanced CKD patients (OR, 4.579 (95% CI, 1.243–16.866)). Conclusions High Hb is associated with an increased risk of in-hospital death in COPD patients with CKD, especially among those with advanced CKD. In this group of patients, attention should be paid to those with high Hb levels.http://link.springer.com/article/10.1186/s12890-019-0933-4Hemoglobin abnormalityIn-hospital mortalityPolycythemiaPopulation-based studyChina collaborative study on acute kidney injury (CCS-AKI)Chronic obstructive pulmonary disease |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Libin Xu Yuanhan Chen Zhen Xie Qiang He Shixin Chen Wenji Wang Guohui Liu Yuanjiang Liao Chen Lu Li Hao Jin Sun Wei Shi Xinling Liang on behalf of China collaborative study on AKI (CCS-AKI) |
spellingShingle |
Libin Xu Yuanhan Chen Zhen Xie Qiang He Shixin Chen Wenji Wang Guohui Liu Yuanjiang Liao Chen Lu Li Hao Jin Sun Wei Shi Xinling Liang on behalf of China collaborative study on AKI (CCS-AKI) High hemoglobin is associated with increased in-hospital death in patients with chronic obstructive pulmonary disease and chronic kidney disease: a retrospective multicenter population-based study BMC Pulmonary Medicine Hemoglobin abnormality In-hospital mortality Polycythemia Population-based study China collaborative study on acute kidney injury (CCS-AKI) Chronic obstructive pulmonary disease |
author_facet |
Libin Xu Yuanhan Chen Zhen Xie Qiang He Shixin Chen Wenji Wang Guohui Liu Yuanjiang Liao Chen Lu Li Hao Jin Sun Wei Shi Xinling Liang on behalf of China collaborative study on AKI (CCS-AKI) |
author_sort |
Libin Xu |
title |
High hemoglobin is associated with increased in-hospital death in patients with chronic obstructive pulmonary disease and chronic kidney disease: a retrospective multicenter population-based study |
title_short |
High hemoglobin is associated with increased in-hospital death in patients with chronic obstructive pulmonary disease and chronic kidney disease: a retrospective multicenter population-based study |
title_full |
High hemoglobin is associated with increased in-hospital death in patients with chronic obstructive pulmonary disease and chronic kidney disease: a retrospective multicenter population-based study |
title_fullStr |
High hemoglobin is associated with increased in-hospital death in patients with chronic obstructive pulmonary disease and chronic kidney disease: a retrospective multicenter population-based study |
title_full_unstemmed |
High hemoglobin is associated with increased in-hospital death in patients with chronic obstructive pulmonary disease and chronic kidney disease: a retrospective multicenter population-based study |
title_sort |
high hemoglobin is associated with increased in-hospital death in patients with chronic obstructive pulmonary disease and chronic kidney disease: a retrospective multicenter population-based study |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2019-09-01 |
description |
Abstract Background Chronic kidney disease (CKD) is a common comorbidity of chronic obstructive pulmonary disease (COPD). Although high hemoglobin (Hb) is detrimental to CKD patients, its relationship with poor outcomes in the COPD population has not been reported. This study aimed to investigate the relationship between high Hb and in-hospital mortality and to explore reference Hb intervals in patients with COPD and CKD. Methods This retrospective study was multicenter population-based. A total of 47,209 patients who presented with COPD between January 2012 and December 2016 were included. The average Hb level during hospitalization was used as the Hb level. CKD and advanced CKD were defined as estimated glomerular filtration rates < 60 and < 30 ml/min/1.73 m2, respectively. The association between Hb level (measured in 1 g/dL intervals) and in-hospital mortality was analyzed in different multivariable logistic regression models by CKD stratification. Results The Hb level was decreased in the CKD subgroup. In the non-CKD group, a higher Hb level was not associated with an increased risk of in-hospital death. However, the Hb level and mortality showed a U-shaped relationship in the CKD group. After adjusting for age and Charlson Comorbidity Index, multivariable regression analysis showed that an Hb level > 17 g/dL was associated with an increased risk of death in the CKD group with an odds ratio (OR) of 2.085 (95% CI, 1.019–4.264). Hb > 14 g/dL was related to an increased risk of death in advanced CKD patients (OR, 4.579 (95% CI, 1.243–16.866)). Conclusions High Hb is associated with an increased risk of in-hospital death in COPD patients with CKD, especially among those with advanced CKD. In this group of patients, attention should be paid to those with high Hb levels. |
topic |
Hemoglobin abnormality In-hospital mortality Polycythemia Population-based study China collaborative study on acute kidney injury (CCS-AKI) Chronic obstructive pulmonary disease |
url |
http://link.springer.com/article/10.1186/s12890-019-0933-4 |
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