[Hospital-acquired anemia and decrease of hemoglobin levels in hospitalized patients]

Abstract

It is common to observe the development of anemia in hospitalized patients, especially in critical cases. Few studies have evaluated its prevalence and associated factors in patients in the general ward. The purpose of this study is to determine the prevalence, characteristics and associated clinical factors of hospital-acquired anemia and the drop of hemoglobin concentration in hospitalized patients. This is a cross-sectional, prospective and descriptive study. A total of 192 consecutive in-patients in the general ward were studied. Associated risk factors to the drop in hemoglobin by ≥ 2g/dl were analyzed; 139 patients (72.4%) presented anemia; 89 of them (46.4%) had it at admission and 50 (26%) developed hospital-acquired anemia, 47 out of 192 showed a drop in hemoglobin ≥ 2 g/dl(24.48%). They also presented lower values of hematocrite and hemoglobin at discharge (p = 0.01), parenteral hydration at a higher volume (p = 0.01), and lengthier hospitalizations (p = 0.0001). In the univariate analysis, the following variables were statistically significant risk factors: leukocytosis ≥ 11000 mm3 (OR; IC95%: 2,02; 1.03-4; p = 0.01), hospitalization days ≥ 7 (OR; IC95%:3.39; 1.62-7.09; p = 0.0006), parenteral hydration ≥ 1500 ml/day (OR; IC95%: 2.47; 1.06-6.4; p = 0.01), central venous access (OR; IC95%:10.29; 1.75-108.07; p = 0.003) and hospital-acquired anemia (OR; IC95%: 7.06; 3.41-15.83; p = 0.00000004). In the multivariate analysis, the following variables were independent predictive factors of the hemoglobin decrease = 2 g/dl: leukocytosis ≥ 11000 mm3 (OR; IC95%: 2.45; 1.14-5,27; p = 0.02), hospitalization days ≥ 7 (OR; IC95%:5.15; 2.19-12.07; p = 0.0002), parenteral hydration ≥ 1500 ml/day (OR; IC95%: 2.95; 1.13-7.72; p = 0.02), central venous access (OR; IC95%:8.82; 1.37-56.82; p = 0.02). Hospital-acquired anemia has a high prevalence. Lengthier stays, presence of leukocytosis, parenteral hydration and central venous access placement are predictive factors of the drop in hemoglobin ≥ 2 g/dl.