ABSTRACT
Chronic obstructive pulmonary disease [COPD] is associated with significant morbidity and mortality worldwide. This disease affects the lungs and organs outside the lungs. The aim of this study was to determine the prevalence of anemia in patients who were referred to teaching hospitals of Tehran University of Medical Sciences, Tehran, Iran. Three hundred ninety two patients with COPD who attended to the teaching hospitals of Tehran University of Medical Sciences, from March to June 2009 were assessed. Laboratory and clinical data of patients was gathered from their medical records. We used global initiative for chronic obstructive lung disease criteria in order to categorize severity of disease in patients. The mean age of patients was 66.5 +/- 12.3 years and 289 [73.7%] subjects were men. The overall prevalence of anemia was 36.7% [95% CI: 31%-41%]. Twenty two females [21.4%] and 110 males [38.1%] were anemic. There was a positive correlation between age and hemoglobin level. In group two [COPD stages I to II], there was 43.5% prevalence of anemia versus 34.1% in group three [COPD stages III to IV]. There was a high prevalence of anemia in patients with COPD. Anemia can limit the physical activity of these patients and worsen dyspnea. Therefore, more attention needs to he given to anemia while managing these patients in clinics
ABSTRACT
The role of initial serum uric acid on admission in critically ill patients is controversial; we presumed that uric acid level can predict the mortality of the admitted patients to intensive care unit as a simple test. Totally 220 consecutively admitted children [96 girls, 124 boys] with mean age 3.5 years, who were at least 24 hours in pediatric intensive care unit [PICU], were enrolled in a prospective cohort study during January 2006 to December 2007. The subsequent PICU admission in the same hospitalization, those who were discharged from the hospital and then re-admitted to the PICU during the observation period, and the patients with chronic renal failure were excluded. Serum uric acid level was measured during the first day of PICU admission. Death or transfer from PICU was considered as final outcome. The statistical analysis was done by suing linear regression analysis, ROC curve, student t-test, and Chi-square. P value less than 0.05 was considered significant. From 44 patients who had serum uric acid level more than 8 mg/dl, 17 cases died showing with a higher relative risk of 1.88, higher mortality [P<0.05]. The relative risk of death in patients who had serum uric acid > 8mg/dl and needed vasopressor was 1.04, and in those under mechanical ventilation 1.33. In patients who scored pediatric risk of mortality of > 38 it was 1.4, and in septic cases 4 [P<0.05]. Stepwise linear regression analysis showed that mainly the need for mechanical ventilation [P=0.001] and vasopressor had statistically significant correlation with the poor outcome [P=0.001]. Uric acid level during the first day of intensive critical care admission is not an independent risk of mortality in PICU. Need for mechanical ventilation or inotropic agents was associated with poor outcome and only higher uric acid level in sepsis played an additive risk factor role