Figure 1.

Curve of mortality risk per Hb categories in men aged > 66 years from the Calgary Community. The curve is J-shaped, with optimal Hb levels minimizing the risk ranging from 140 to 170 g/L (green area). Red point and arrow indicate how the patient described in the case vignette is positioned in the curve, with an ensuing mortality risk increased by 3-fold. ∗Adjusted for age, diabetes mellitus, glomerular filtration rate, and comorbidity status calculated using a validated chronic disease score. See also discussion on the “Definition of AE: a still unresolved issue,” “Prevalence of anemia in elderly: a public health problem,” and “Clinical relevance of anemia in elderly: not an innocent bystander” sections. Adapted from Culleton et al.¹⁴ In the original publication, the fully adjusted hazard ratio for mortality in all subjects (both men and women) older than 80 years with Hb < 110 g/L and normal glomerular filtration rate was 3.34, 95% confidence interval 2.47 to 4.51. Hb = hemoglobin.