Hemoglobin concentration variations over time in general medical inpatients
✍ Scribed by Languasco Agustin; Cazap Nicolas; Marciano Sebastian; Huber Marina; Novillo Abel; Poletta Fernando; Milberg Matias; Riveros Dardo
- Publisher
- John Wiley and Sons
- Year
- 2010
- Tongue
- English
- Weight
- 219 KB
- Volume
- 5
- Category
- Article
- ISSN
- 1553-5592
- DOI
- 10.1002/jhm.650
No coin nor oath required. For personal study only.
✦ Synopsis
Abstract
BACKGROUND:
A decrease in hemoglobin concentration [Hb] with no apparent cause is frequently observed in critically ill patients. Scarce information is available about this situation in general ward‐admitted patients (GWAP).
OBJECTIVES:
To describe [Hb] variation with no obvious cause in GWAP, and to estimate the prevalence and predictors of patients with [Hb] decreases ≥1.5 g/dL.
DESIGN, SETTING AND PATIENTS:
Prospective, observational study in internal medicine GWAP, carried out at two teaching hospitals in Buenos Aires, Argentina. Patients with a history of, or admitted for diseases associated with decreases in [Hb], as well as those with length of stay less than three days, were excluded.
MEASUREMENTS:
Upon hospitalization, complete personal and clinical data were recorded. Furthermore, Katz index, APACHE II acute physiology score (APS) and Charlson score were calculated. [Hb] and hematocrit (HCT) were also assessed during hospitalization.
RESULTS:
A total of 338 patients were evaluated, 131 were included. A mean [Hb] decrease of 0.71 g/dL was observed between admission and discharge (P < 0.001; 95% CI, 0.47‐0.97). Forty‐five percent of the included patients had decreases in [Hb] ≥ 1.5 g/dL. This was associated with a higher APS, a higher [Hb] at admission, and a discharge diagnosis of infectious or gastrointestinal disease. No bleeding episodes were observed.
CONCLUSIONS:
An [Hb] decrease was frequently observed during GWAP hospitalization with no evident blood loss. Even though this decrease has multiple causes, the severity of the acute illness seems to play a major role. Journal of Hospital Medicine 2010;5:283–288. © 2010 Society of Hospital Medicine.