In-hospital Acquired Anemia in Acute Coronary Syndrome. Predictors, In-hospital Prognosis and One-year Mortality

Meroño, Oona; Cladellas, Mercè; Recasens, Lluís; García-García, Cosme; Ribas, Núria; Bazán, Víctor; Farré, Núria; Sainz, Álvaro Chaparro; Comín, Josep; Bruguera, Jordi

doi:10.1016/j.rec.2012.03.008

Cited by 22 publications

(12 citation statements)

References 37 publications

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“…Others have similarly shown that HAA is common among patients hospitalized with AMI and is associated with greater mortality. 5,9,18 Our study extends upon this prior research by showing that severe HAA increases the risk for adverse outcomes for all adult inpatients, not only those hospitalized for AMI or among those receiving blood transfusions.…”

Section: Discussionsupporting

confidence: 71%

Incidence, Predictors, and Outcomes of Hospital‐Acquired Anemia

Makam

Nguyen

Clark

et al. 2017

Journal of Hospital Medicine

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BACKGROUND Although hypothesized to be a hazard of hospitalization, it is unclear whether hospital‐acquired anemia (HAA) is associated with increased adverse outcomes following discharge. OBJECTIVE To examine the incidence, predictors, and postdischarge outcomes associated with HAA. DESIGN Observational cohort study using electronic health record data. SUBJECTS Consecutive medicine discharges between November 1, 2009 and October 30, 2010 from 6 Texas hospitals, including safety‐net, teaching, and nonteaching sites. Patients with anemia on admission or missing hematocrit values at admission or discharge were excluded. MEASURES HAA was defined using the last hematocrit value prior to discharge and categorized by severity. The primary outcome was a composite of 30‐day mortality and nonelective readmission. RESULTS Among 11,309 patients, one‐third developed HAA (21.6% with mild HAA; 10.1% with moderate HAA; and 1.4% with severe HAA). The 2 strongest potentially modifiable predictors of developing moderate or severe HAA were length of stay (adjusted odds ratio [OR], 1.26 per day; 95% confidence interval [CI], 1.23‐1.29) and receipt of a major procedure (adjusted OR, 5.09; 95% CI, 3.79‐6.82). Patients without HAA had a 9.7% incidence for the composite outcome versus 16.4% for those with severe HAA. Severe HAA was independently associated with a 39% increase in the odds for 30‐day readmission or death (95% CI, 1.09‐1.78). Most patients with severe HAA (85%) underwent a major procedure, had a discharge diagnosis of hemorrhage, and/or a discharge diagnosis of hemorrhagic disorder. CONCLUSIONS Severe HAA is associated with increased odds for 30‐day mortality and readmission after discharge; however, it is uncertain whether severe HAA is preventable.

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Section: Discussionsupporting

confidence: 71%

Incidence, Predictors, and Outcomes of Hospital‐Acquired Anemia

Makam

Nguyen

Clark

et al. 2017

Journal of Hospital Medicine

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“…It is obvious that patients after AMI with anemia have greater cardiovascular risk [1][2][3][4][5][6], whereas in patients without anemia at admission the risk stratification remains equivocal. Easy and cheap parameters that would help in a better determination of prognosis are needed.…”

Section: Introductionmentioning

confidence: 99%

Could an analysis of mean corpuscular volume help to improve risk stratification in non-anemic patients with acute myocardial infarction?

et al. 2015

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“…In addition to the cost of the test itself, overutilization also leads to increased phlebotomy, which can lead to patient discomfort and hospital-acquired anemia. In turn, hospital-acquired anemia has been associated with increased blood transfusions, length of stay, and mortality (2)(3)(4)(5)(6). Furthermore, the results of laboratory tests must be reviewed by the clinician and can trigger additional downstream tests and interventions, each of which carries costs and risks.…”

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confidence: 99%