Hospital Acquired Decline in Hemoglobin in Non-Bleeding Patients Admitted to General Medical Wards of a Public Hospital in Northern India

Abstract

Background: A decline in hemoglobin levels with no apparent cause is known to occur in ICU patients during their hospital stay. Less information is available about patients admitted in general medical wards. In countries like India, having high overall prevalence of anemia, further decrease in hemoglobin due to hospital related factors can have a pronounced effect on patient recovery and prognosis. To the best of our knowledge, this is the first study which aims to determine the decrease in hemoglobin in general medical ward patients during their hospital stay in a tertiary care public hospital in India, and to explore related variables.
Methods: A prospective observational study carried out in a tertiary care public hospital in northern India, including 100 patients with no obvious cause for hemoglobin decline. Hemoglobin difference between admission and discharge was determined and association with various factors was studied.
Results: A total of 67 patients showed a decline in hemoglobin with average decline being 0.37 gm%. Significant decline (>1.5 gm %) was observed in 13 patients. Statistically significant association was obtained between hemoglobin decline and sex, discharge diagnosis and IV fluid units infused.
Conclusion A majority of patients showed a definite decline in hemoglobin. The average overall decline as well as the proportion of patients showing significant decline was much less than what was previously observed in ICU patients and in western settings.