Determining the Prevalence of Hospital-Acquired Anemia in the Intensive Care Unit at a Florida Hospital

Background Hospital-acquired anemia (HAA), which negatively affects morbidity, mortality, and resource use, is a common iatrogenic effect of hospitalization, especially in intensive care units. Contributing factors include phlebotomy, intravenous fluid resuscitation, and medications. Objective To determine the prevalence of HAA among adult patients in a southwest Florida intensive care unit and evaluate the relationship between decline in hemoglobin level and length of intensive care unit stay. Methods A retrospective, exploratory medical record review of a 6-month convenience sample (N = 151) was conducted. Hospital-acquired anemia was defined as a 10% or greater decline in hemoglobin level from admission to discharge. Results Of 108 patients meeting inclusion criteria, 69 (64%) developed HAA. Stays were significantly longer for the 69 patients with HAA than for the 39 patients without HAA (mean [SD], 5.9 [5.8] days vs 3.3 [3.6] days; P = .005). The mean (SD) decline in hemoglobin level was 20% (8%) for patients with HAA and 4% (2%) for patients without HAA (P < .001). A sensitivity analysis excluding 6 outliers (n = 102) confirmed that stays were significantly longer for patients with HAA than for patients without HAA (mean [SD], 5.1 [4.2] days vs 2.8 [1.7] days; P < .001). Conclusion Hospital-acquired anemia is prevalent in this intensive care unit and correlates with longer stays. Although causality regarding phlebotomy was not directly measured, the high prevalence of HAA supports implementing blood conservation strategies to improve clinical outcomes and reduce iatrogenic blood loss.