Abstract
OBJECTIVE: This secondary analysis aimed to examine the association between hemoglobin levels and mortality in older Japanese individuals with dysphagia. METHODS: Data from 253 patients with clinically confirmed dysphagia between January 2014 and January 2017 were analyzed. Participants were divided into three tertiles based on their hemoglobin levels (T1: 5.4-10.2 g/dL; T2: 10.2-12.0 g/dL; T3: ≥12.0 g/dL). Cox proportional hazards regression was used to evaluate mortality risk, supplemented by Kaplan-Meier survival analysis and subgroup interaction assessments. RESULTS: The study included 154 female and 99 male patients, with a median age of 83 years. The cohort demonstrated a significant inverse relationship between hemoglobin levels and mortality. After full covariate adjustment, each 1 g/dL increase in hemoglobin level corresponded to a 14% mortality risk reduction (HR = 0.86, 95% CI: 0.77-0.97, P = 0.013). Compared to T1, adjusted hazard ratios for T2 and T3 were 0.53 (95% CI: 0.34-0.84, P = 0.007) and 0.48 (95% CI: 0.27-0.83, P = 0.009), respectively (P for trend = 0.005). Median survival differed significantly across tertiles: 212 days (T1), 540 days (T2), and >1463 days (T3) (P < 0.0001). Subgroup analyses confirmed the robustness without significant interactions. CONCLUSION: Hemoglobin concentration was independently and inversely associated with mortality in older Japanese patients with dysphagia. These findings underscore the prognostic value of hemoglobin in this population.