J Korean Crit Care Nurs.  2019 Feb;12(1):94-108. 10.0000/jkccn.2019.12.1.94.

Anemia as a Risk Factor of Mortality and Rehospitalization in Patients with Heart Failure : An Integrative Review

  • 1Professor, Red Cross College of Nursing, Chung-Ang University, Seoul, Korea.
  • 2Associate Professor, College of Nursing, Gachon University, Incheon, Korea. bhkim@gachon.ac.kr


Heart failure (HF) is considered an important medical burden with rehospitalization and mortality. Anemia is a major risk factor associated with the severity of HF. To improve the understanding of the impact of anemia in the population with HF, we explored the prevalence of anemia, its guidelines, relationship between anemia and mortality or rehospitalization, and limitation of reviewed papers of various populations with HF.
We used Whittemore and Knafl's integrative review methodology (2005), and thirty research papers were analyzed. PubMed, CINAHL, Cochrane, PsychInfo, Embase, Web of Science were searched for papers published between January 1960-June 2018.
Anemia in individuals with HF was primarily defined using the World Health Organization guideline. The prevalence of anemia in patients with HF varied from 9% to 56.7%. Moreover, such a condition significantly increases the prevalence of mortality or rehospitalization in patients with HF. The analyzed majority were non-prospective cohort study including secondary data analysis.
Anemia in individuals with HF is a significant risk factor of mortality and rehospitalization. Prospective cohort studies should be designed to identify the optimal value for screening anemia and the impact of anemia on rehospitalization and mortality among HF patients.


Heart failure; Anemia; Mortality; Hospitalization; Review
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