C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy.
Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Intern Emerg Med. 2023 Jan;18(1):177-183. doi: 10.1007/s11739-022-03147-x. Epub 2022 Nov 8.
Hospital-acquired anemia is defined as a new-onset anemia in hospitalized patients who have a normal hemoglobin level at admission. Its prevalence is unknown and most studies published on this topic have been conducted in intensive care unit patients with limited applicability to less acute settings, such as internal medicine wards. We conducted a retrospective study and enrolled 129 patients who were admitted to an Internal Medicine Unit between October 2021 and February 2022. The median value of phlebotomy during hospitalization was 46 ml (IQR 30-72 ml), whereas the median length of hospital stay was 9 days (IQR 5-13 days). The median value of hemoglobin reduction was -0.63 g/dl (p < 0.001) and the maximum value of drop in hemoglobin value was -2.6 g/dl. All patients who experienced a phlebotomy > 85 ml had a hemoglobin reduction > 0.6 g/dl. 20.9% of patients developed anemia during the hospital stay (7% moderate and 13.9% mild). No cases of severe anemia were observed. The volume of blood drawn during the hospital stay and the Hb value on admission were the only two variables statistically associated with the development of anemia, whereas gender, age, and chronic diseases, such as diabetes, history of cancer, or heart failure, were not. Strategies, such as elimination of unnecessary laboratory tests and the use of smaller tubes for blood collection, are needed to reduce the volume of iatrogenic blood loss and avoid blood wastage occurring during hospitalization in internal medicine patients.
医源性贫血定义为在入院时血红蛋白水平正常的住院患者中发生的新发贫血。其患病率尚不清楚，大多数关于该主题的研究都是在重症监护病房患者中进行的，这些研究对内科病房等不太急性的环境的适用性有限。我们进行了一项回顾性研究，共纳入了 129 名于 2021 年 10 月至 2022 年 2 月期间入住内科病房的患者。住院期间采血的中位数为 46ml（IQR 30-72ml），而住院时间的中位数为 9 天（IQR 5-13 天）。血红蛋白下降的中位数为-0.63g/dl（p<0.001），血红蛋白值下降的最大值为-2.6g/dl。所有经历采血量>85ml 的患者血红蛋白下降均>0.6g/dl。20.9%的患者在住院期间发生贫血（7%为中度，13.9%为轻度）。未观察到严重贫血病例。住院期间采血量和入院时的 Hb 值是与贫血发生唯一具有统计学相关性的两个变量，而性别、年龄以及糖尿病、癌症史或心力衰竭等慢性疾病则无相关性。需要采取策略，例如消除不必要的实验室检查和使用较小的采血管，以减少医源性失血的量，并避免内科患者住院期间发生血液浪费。
