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Historically, especially before the introduction of domiciliary oxygen, secondary polycythemia was a striking feature in COPD, but today the prevalence seems to be low. Both low and high values are encountered in COPD, though the distribution varies highly with the population studied. Hemoglobin has been suggested as an easily and inexpensively measured prognostic indicator. 2 – 8 Recently developed prognostic tools take this multifaceted pathology into account by incorporating systemic as well as lung-specific parameters.

Instead, COPD is a complex interplay between emphysema and airway obstruction, systemic inflammation, comorbidities, and metabolism, which all contribute to prognosis. Our understanding of COPD has evolved rapidly, and it has become clear that COPD is not an isolated disease of the lungs. 1 It is among the leading causes of mortality and morbidity worldwide, and is predicted to be the third-leading cause of death by 2020. In conclusion, low concentrations of hemoglobin are frequent in COPD patients with acute exacerbations, and predict long-term mortality.ĬOPD is a persistent, progressive airflow limitation associated with enhanced chronic inflammatory response in the airways. After discharge, compared to hemoglobin 130 g/L, the hazard ratio (HR) for males with hemoglobin 120 g/L was 1.45 (95% confidence interval 1.22–1.73), adjusted HR 1.37 (95% CI 1.15–1.64). The in-hospital mortality rates for patients with hemoglobin below or above these limits were 11.6% and 5.4%, respectively. Hemoglobin below 130 g/L was present in 39% of males and below 120 g/L in 24% of females. Sex-specific survival analyses were fitted for different rounded concentrations of hemoglobin. Age, sex, comorbidities, medication, renal function, and concentrations of hemoglobin were retrieved. A register-based cohort of patients admitted for the first time to Danish hospitals for acute exacerbations of COPD from 2007 through 2012 was established. There is evidence of anemia as a prognostic factor in acute exacerbations, but the detailed relationship between concentrations of hemoglobin and mortality is not known. Low concentrations of hemoglobin have previously been demonstrated in many patients with COPD.