Is it safe to discharge geriatric trauma patients with anemia? - 24/04/18

Doi : 10.1016/j.amjsurg.2017.10.050

Adrian W. Ong ^a,^⁎ , Nick R. Jaisingh ^b, Susan Butler ^c, Adam Sigal ^d, Forrest B. Fernandez ^a
^a Section of Trauma and Acute Care Surgery, Department of Surgery, Reading Health System, Reading, PA 19611, USA
^b Alvernia University, Reading, PA 19607, USA
^c Children's Health Center, Reading Health System, Reading PA 19611, USA
^d Department of Emergency Medicine, Reading Health System, Reading PA 19611, USA

^∗Corresponding author. Section of Trauma, Department of Surgery, Sixth Ave and Spruce St, Reading, PA 19611, USA.Section of TraumaDepartment of SurgerySixth Ave and Spruce StReadingPA19611USA

Abstract

Introduction

The consequences of discharging anemic geriatric trauma patients are not well studied. We hypothesize that anemia at discharge is associated with adverse outcomes.

Methods

A 1-year retrospective review of patients ≥65 years was performed. Hemoglobin levels at admission (HbA), discharge (HbD) and the lowest inpatient level (HbL) were recorded. Severity of anemia was categorized as mild (Hb ≥ 10.0 g/dl), moderate (Hb < 10.0 and ≥ 8.5 g/dl) and severe (Hb < 8.5 g/dl). The study endpoint was death or unplanned readmission 60 days following discharge. Univariate and multivariable analysis were used to determine if anemia predicted the outcome. A p value of 0.05 was considered significant.

Results

550 patients were included. Moderate and severe anemia for HbA each predicted the study endpoint. Both HbD and HbL were highly correlated with HbA but did not predict the study endpoint.

Conclusion

The degree of discharge anemia was not predictive of 60-day mortality or unplanned admissions in geriatric trauma patients.

Le texte complet de cet article est disponible en PDF.

Highlights

•	In elderly trauma patients, anemia on admission predicted 60-day mortality and unplanned admission.
•	Anemia at discharge did not predict the study endpoint.
•	Need for inpatient blood transfusion did not predict endpoint.

Le texte complet de cet article est disponible en PDF.

Keywords : Anemia, Mortality, Transfusion, Trauma, Readmission