Abstract
AimInvestigating the prevalence of hospital-acquired anaemia in a United Kingdom (UK) secondary care setting to describe the level of appropriate management prior to discharge back to primary care.Design and settingsAn observational study of 13 medical and surgical wards in a UK district general hospital.MethodSingle-day examination of notes, blood results and drug charts, with a 30-day follow up, using pre-set definitions of anaemia and exclusion criteria.ResultsTwo hundred and sixty-seven patients were included. Of them, 52% were anaemic on admission, 62.2% were anaemic on the study day, 16% had hospital-acquired anaemia and 49%-82% had no biochemical indices checked during the admission or in the last 12 months. Also, 53% of anaemic patients are being discharged without appropriate treatment, with over a third being under-investigated.ConclusionThe prevalence of anaemia in a UK district general hospital is high. Causes of anaemia are complex, posing a potentially modifiable risk factor for falls, readmission and mortality.
Highlights
Anaemia is a common medical diagnosis, affecting 24.8% of the world’s population [1]
52% were anaemic on admission, 62.2% were anaemic on the study day, 16% had hospital-acquired anaemia and 49%-82% had no biochemical indices checked during the admission or in the last 12 months
American studies report that 30%-75% of patients admitted to secondary care will develop hospital-acquired anaemia (HAA), but there is a lack of data in the United Kingdom (UK) on this prevalence [6,7]
Summary
Anaemia is a common medical diagnosis, affecting 24.8% of the world’s population [1]. Patients admitted into hospitals are at risk of becoming anaemic from blood loss, nutritional issues or chronic disease [5]. American studies report that 30%-75% of patients admitted to secondary care will develop hospital-acquired anaemia (HAA), but there is a lack of data in the UK on this prevalence [6,7]. In New Zealand, a study on anaemia recognised that it was not well documented or investigated in the secondary care setting despite being a modifiable risk factor and a cancer diagnosis opportunity [2]. We rely on General Practitioners (GPs) to identify and characterise anaemia in the UK, managing anaemia in primary care has been cited as a challenge; with under investigation remaining the predominant issue despite the availability of guidelines [8,9]. Given that some studies have demonstrated that almost half of elderly patients with an identified iron deficiency anaemia (IDA) have a gastrointestinal tract abnormality [10,11]; and with many anaemic patients being admitted having worse anaemia on discharge, there is a need to review UK practices in order to understand the current practice and identify areas for further research and improvement across the National Health Service (NHS)
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