Morbidity and Mortality in Anemia

A growing body of research suggests that anemia is independently associated with morbidity and mortality in the general population as well as in patients with chronic diseases where the prevalence of anemia is high (1-4). Anemia prognosis depends on the underlying cause of the anemia. However, the severity of the anemia, its etiology, and the rapidity with which it develops can each play a significant role in the prognosis. Similarly, the age of the patient and the existence of other co-morbid conditions influence outcome. Higher mortality rates are almost always observed in patients with anemia. Many studies (511) identified anemia as an independent factor impacting mortality and provided the evidence that management of anemia, independent of other risk factors, improves mortality rates. In one study (3), independent of the underlying disease, anemia was associated with increased mortality in chronic kidney disease, congestive heart failure and acute myocardial infarction patients; increased morbidity in chronic kidney disease, congestive heart failure and cancer radiotherapy patients; and decreased quality of life in chronic kidney disease and cancer patients. In addition to its impact upon mortality, anemia also significantly influences morbidity. Multiple studies support this assertion especially in patients with chronic kidney disease and heart failure (12-17).