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    Anemia in hospitalized patients: an overlooked risk in medical care

    Access Status
    Fulltext not available
    Authors
    Krishnasivam, D.
    Trentino, K.
    Burrows, S.
    Farmer, Shannon
    Picardo, S.
    Leahy, M.
    Halder, A.
    Chamberlain, J.
    Swain, S.
    Muthucumarana, K.
    Waterer, G.
    Date
    2018
    Type
    Journal Article
    
    Metadata
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    Citation
    Krishnasivam, D. and Trentino, K. and Burrows, S. and Farmer, S. and Picardo, S. and Leahy, M. and Halder, A. et al. 2018. Anemia in hospitalized patients: an overlooked risk in medical care. Transfusion. 58 (11): pp. 2522-2528.
    Source Title
    Transfusion
    DOI
    10.1111/trf.14877
    ISSN
    0041-1132
    School
    Centre for Population Health Research
    URI
    http://hdl.handle.net/20.500.11937/72903
    Collection
    • Curtin Research Publications
    Abstract

    © 2018 AABB BACKGROUND: This study investigated the association between nadir anemia and mortality and length of stay (LOS) in a general population of hospitalized patients. STUDY DESIGN AND METHODS: A retrospective cohort study of tertiary hospital admissions in Western Australia between July 2010 and June 2015. Outcome measures were in-hospital mortality and LOS. RESULTS: Of 80,765 inpatients, 45,675 (56.55%) had anemia during admission. Mild and moderate/severe anemia were independently associated with increased in-hospital mortality (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.36-1.86, p = 0.001; OR 2.77, 95% CI 2.32-3.30, p < 0.001, respectively). Anemia was also associated with increased LOS, demonstrating a larger effect in emergency (mild anemia—incident rate ratio [IRR] 1.52, 95% CI 1.48-1.56, p < 0.001; moderate/severe anemia—IRR 2.18, 95% CI 2.11-2.26, p < 0.001) compared to elective admissions (mild anemia—IRR 1.30, 95% CI 1.21-1.41, p < 0.001; moderate/severe anemia—IRR 1.69, 95% CI 1.55-1.83, p < 0.001). LOS was longer in patients who developed anemia during admission compared to those who had anemia on admission (IRR 1.13, 95% CI 1.10-1.17, p < 0.001). Red cell transfusion was independently associated with 2.23 times higher odds of in-hospital mortality (95% CI 1.89-2.64, p < 0.001) and 1.31 times longer LOS (95% CI 1.25-1.37, p < 0.001). CONCLUSION: More than one-third of patients not anemic on admission developed anemia during admission. Even mild anemia is independently associated with increased mortality and LOS; however, transfusion to treat anemia is an independent and additive risk factor.

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