Too Many Hospital Blood Tests

Heart attack patients developing hospital acquired anemia from blood loss

August 11, 2011 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) Taking a diagnostic blood test while hospitalized is a fairly routine process. Most don't think twice about them. But for heart attack patients, such tests could lead to hospital-acquired anemia.

It could be preventable in patients with acute myocardial infarction, a type of heart attack. Limiting the number of blood draws or reducing volume taken could combat the problem. The risk of developing hospital-acquired anemia increased by 18 percent for each 50 milliliters of blood drawn.

"Request only required blood draws while hospitalized."

Dr. Adam C. Salisbury from Saint Luke's Mid America Heart and Vascular Institute said that blood loss from phlebotomy is substantial in patients with myocardial infarction, though it varies across hospitals.

Anemia is a condition that occurs when the body does not have enough healthy red blood cells. It is linked to greater mortality and a worse health status in heart attack patients regardless of whether it was present previously or acquired while hospitalized. Some patients also may need blood transfusions.

Researchers analyzed data from the Cerner Corp.'s Health Facts database, which included 17,676 patients between January 2000 and December 2008. The patients all were admitted with myocardial infarction, but not anemia, at one of 57 hospitals.

In order to measure the blood loss, investigators identified all phlebotomy events in patient records. They considered the types of tests ordered and the amount of blood required for each.

About 20 percent of patients developed moderate to severe hospital-acquired anemia. Blood loss for these patients was estimated to be 173.8 milliliters, almost 100 milliliters more than the estimated blood loss in those who did not develop moderate to severe anemia while hospitalized.

The report was published Online First by Archives of Internal Medicine, one of the Journal of the American Medical Association/Archives journals.