Acute blood loss anemia in hospitalized patients is associated with adverse outcomes: An analysis of the Nationwide Inpatient Sample.

ABSTRACT

BACKGROUND: Acute blood loss anemia is the most common form of anemia and often results from traumatic injuries or gastrointestinal bleeding. There are limited studies analyzing outcomes associated with acute blood loss anemia in hospitalized patients. METHODS: The Nationwide Inpatient Sample (NIS) was analyzed from 2010 to 2014 (n = 133,809). The impact of acute blood loss anemia on in-hospital mortality, length of stay (LOS), healthcare cost, and disposition was determined using regression modeling adjusted for age, gender, race, and comorbidities. RESULTS: Hospitalized patients with acute blood loss anemia had significantly higher healthcare cost (adj OR 1.04; 95% CI 1.04-1.05), greater lengths of stay (adj OR 1.18; 95% CI 1.17-1.18), and were less likely to be discharged home compared to the general medical population (adj OR 0.27; 95% CI 0.26-0.28). Acute blood loss anemia was associated with increased risk for mortality in unadjusted models (unadj 1.16; 95% CI 1.12-1.20) but not in adjusted models (adj OR 0.91; 95% CI 0.88-0.94). When analyzing comorbidities, a "muscle loss phenotype" had the strongest association with mortality in patients with acute blood loss anemia (adj OR 4.48; 95% CI 4.35-4.61). The top five primary diagnostic codes associated with acute blood loss anemia were long bone fractures, GI bleeds, cardiac repair, sepsis, and OB/Gyn related causes. Sepsis had the highest association with mortality (18%, adj OR 2.59; 95% CI 2.34-2.86) in those with acute blood loss anemia. CONCLUSIONS: Acute blood loss anemia is associated with adverse outcomes in hospitalized patients.