Is it safe to discharge geriatric trauma patients with anemia?

Am J Surg. 2018 Mar;215(3):419-422. doi: 10.1016/j.amjsurg.2017.10.050. Epub 2017 Nov 11.


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.

Keywords: Anemia; Mortality; Readmission; Transfusion; Trauma.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anemia / complications*
  • Anemia / diagnosis
  • Anemia / mortality
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Patient Discharge*
  • Patient Readmission / statistics & numerical data*
  • Patient Safety*
  • Pennsylvania / epidemiology
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Wounds and Injuries / complications*
  • Wounds and Injuries / mortality