Friday, August 12, 2011

HCFI Update:Hospital-acquired anemia can increase mortality in acute heart attack


For patients hospitalized with an acute heart attack an increasing volume of blood drawn for diagnostic tests is associated with a greater risk of developing anemia. For every 50 mL of blood drawn, the risk of developing moderate-to-severe anemia in the hospital rises by 18%, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

It is possible to reduce this risk by

1. Reviewing the necessity for routine vein puncture
2. Reducing the volume of blood obtained during a hospitalization.
3. Enlisting the minimum amount of blood required for each test
4. Limiting scheduled phlebotomy
5. Using pediatric blood tubes for blood collection
6. Using 2 or 5 ml syringes instead of 10 ml syringes
7. Using stored serum specimens or storing the first sample of the patient till the day of hospitalization.
8. Rationalization of the routine testing

According to Dr Mikhail Kosiborod, of Saint Luke's Mid America Heart and Vascular Institute in Kansas who published their data in the Archives of Internal Medicine, hospital-acquired anemia in patients with acute heart attack is associated with poorer outcomes including higher mortality. He evaluated 17,676 patients with acute heart attack from 57 U.S. hospitals. The patients had normal hemoglobin levels at admission. Overall, 20.1% of the patients developed moderate-to-severe anemia (a decline in hemoglobin from normal values to less than 11 g/dL) during their hospital stay. The mean volume of blood drawn was significantly higher in patients who developed moderate-to-severe anemia (173.8 versus 83.5 mL). Those who developed the condition were also more likely to have more than 300 mL drawn (12.5%) and more than 500 mL drawn (3.8%).

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