The negative prognostic synergism of anemia and heart disease in female nursing home residents.

This study assessed functional and cognitive status, hemoglobin, serum creatinine, and heart disease from chart reviews in 441 female nursing home residents (mean age 86.8 +/- 7.5 years) and correlated the findings with 1-year survival. Independent predictors of outcome were older age (hazard ratio [HR] 1.76, 95% confidence interval [CI] 1.13 to 2.73), Barthel index (HR 0.31, 95% CI 0.15 to 0.62), and the combined presence of anemia (hemoglobin < or =11 g/dl) and heart disease (HR 3.50, 95% CI 1.50 to 7.47). Survival rates were 92% in the reference group with neither anemia nor heart disease, 91% in anemic subjects without heart disease, 87% in nonanemic patients with heart disease, and 72% in women with the 2 conditions (p <0.001). Anemia is highly prevalent in this population and when present in subjects with heart disease determines a threefold increase in mortality risk.