Prevalence of Anemia in Patients with COPD and Its Potential Impact on Morbidity of COPD Patients

Background: Although COPD is traditionally associated with polycythemia, the systemic inflammation that is now recognized as a feature of COPD makes it a possible cause of Anemia of Chronic Disease (ACD). Preliminary evidences suggest that anemia in COPD may be more prevalent than expected occurring in 10% - 15% of patients. While in states like chronic heart failure and renal insufficiency, anemia has been extensively studied; little attention has been given to it in COPD. Objectives: To see the prevalence of anemia in patients with COPD and its potential impact on morbidity of COPD patients. Design and Setting: A university hospital-based cross-sectional study in Kashmir, India. Methods: Two hundred patients (119 males and 81 females) with spirometery documented COPD were evaluated for frequency of anemia. In addition to routine investigations, erythropoietin levels were done in a subgroup of patients. Results: A total of 36 cases (20 males and 16 females) of anemia were detected giving a frequency of 18%. Normocytic normochromic type of anemia was present in 32 (88.89%) patients while the rest had normocytic hypochromic type of anemia. Majority of patients were in GOLD stage 11 and had decreased serum iron, transferrin saturation and TIBC. Erythropoietin levels were significantly raised in anemic COPD patients compared to non-anemic COPD patients. The various factors significantly associated with anemia were: No. of exacerbations of COPD, No. of hospital admissions, BMI and erythropoietin levels. Conclusion: Anemia occurs frequently in patients of COPD and is associated with increased morbidity in the form of No. of exacerbations and hospital admissions. Correcting anemia in these patients may improve their clinical outcome.