Hemoglobin Predicts Mortality Risk in Geriatric Patients with Dysphagia: A Japanese Retrospective Cohort Study

Background: Hemoglobin (Hb) is an established prognostic biomarker in several conditions, but its prognostic value in elderly patients with dysphagia is unclear. Objective: To evaluate whether Hb concentration predicts all cause mortality in Japanese geriatric patients with dysphagia. Methods: We performed a retrospective secondary analysis of a publicly available Japanese cohort (Dryad; n = 253; Jan 2014–Jan 2017). Hemoglobin measured ≤7 days before nutritional support initiation was analyzed as a continuous variable and by tertiles (T1 < 9 g/dL; T2 9–12 g/dL; T3 ≥12 g/dL). Cox proportional hazards models estimated associations (Models I–III: unadjusted to fully adjusted). Survival probabilities were assessed by Kaplan–Meier analysis; subgroup interactions were tested. Results: Median age was 83 years (n = 253; 154 females). In multivariable analysis Hb (per 1 g/dL) was independently associated with lower mortality (adjusted HR = 0.83; 95% CI: 0.76–0.91; P < 0.001). Compared with T1, adjusted HRs were 0.62 (95% CI: 0.41–0.93; P = 0.021) for T2 and 0.36 (95% CI: 0.21–0.60; P < 0.001) for T3. Median survival increased across tertiles (T1:185 days; T2:309 days; T3:405 days; log‑rank P < 0.001). No significant subgroup interactions were observed. Conclusion: Higher hemoglobin concentration independently predicted reduced mortality in this Japanese geriatric dysphagia cohort, supporting routine Hb monitoring to inform nutritional and prognostic care.