Effects of hemoglobin level on prognosis in elderly male inpatients:a retrospective cohort study
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(1. Medical School of Chinese PLA, Beijing 100853, China;2. National Clinical Research Center for Geriatric Diseases, ;3. Department of Nephrology, Second Medical Center, Chinese PLA General Hospital, Beijing 100853, China)

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R592

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    Abstract:

    Objective To explore the impact of hemoglobin (Hb) levels on the prognosis of the elderly male inpatients, and to analyze the optimal Hb range for those with renal insufficiency. Methods A retrospective analysis was made of the clinical data of 1 623 elderly male patients admitted to the National Geriatric Clinical Medical Research Center of Chinese PLA General Hospital from January 2008 to December 2010. The patients were divided into four groups based on Hb levels:413 in the Hb≤110 g/L group, 139 in the 110 g/L130 g/L group. According to the baseline renal function on admission, the patients were divided into a renal insufficiency group [eGFR<60 ml/(min·1.73m2); n=357] and a normal renal function group [eGFR≥60 ml/ (min·1.73) m2; n=1266]. SPSS 25.0 was used for data analysis, and Kaplan Meier survival curve for the difference in cumulative survival rate and cumulative incidence of acute myocardial infarction between the patients with different Hb levels. The correlation analysis was conducted using a Cox proportional risk regression model. Results During the 5-year follow-up, all-cause mortality occurred in 617 patients (38.0%), and acute myocardial infarction in 254 (15.7%). Kaplan Meier survival curve analysis showed that the cumulative all-cause mortality rate and incidence of acute myocardial infarction were the lowest in the Hb>130 g/L group, and the highest in the Hb≤110 g/L group. There were statistically significant differences in log rank tests between the two groups (P<0.05 for both). Cox proportional risk regression analysis of patients with renal insufficiency showed that, compared with the Hb≤110 g/L group, the 120g/LHR=0.43,95%CI 0.25-0.73; P=0.002) and Hb>130 g/L group (HR=0.46,95%CI 0.24-0.87; P=0.017) had a significantly reduced risk of all-cause mortality, and the 120 g/LHR=0.31,95%CI 0.14-0.69; P=0.004) had a significantly reduced risk of acute myocardial infarction. Conclusion Higher Hb levels in the elderly male inpatients can reduce all-cause mortality and the incidence of acute myocardial infarction. For patients with renal insufficiency, there is an optimal Hb range. Hb>120 g/L is associated with a lower risk of all-cause mortality, and 120 g/L

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History
  • Received:December 09,2022
  • Revised:
  • Adopted:
  • Online: June 26,2023
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