By: Neel Duggal Oct. 16, 2017
Sometimes, doctors will recommend a blood transfusion as a treatment option for someone with anemia. Typically, this is done in more extreme cases. Adding blood from a non-anemic person can help treat the anemia quickly and provide the body with a source of iron. However, the clinical impact on these patients is usually short-term and little data research has assessed the effect of blood transfusions on important health quality outcomes.
To assess the relationship between blood transfusions, anemia, and quality outcomes, Dexur data scientists analyzed data on the total number of patients with anemia and looked at what percentage of these patients had also received a blood transfusion. These scientists subsequently examined the difference in two quality measurement outcomes - average days in length of stay and average difference in readmission rates – between the group of anemic patients that received a blood transfusion and those that did not. All of this data was then organized by 54 separate US states and territories.
In general, the data showed that a sizable minority of patients with anemia received blood transfusions. For example. In California, 15.02% of the 2,932,623 inpatient anemia discharges also received a blood transfusion. In general, these patients stayed an average of 1.8 days longer than anemic patients who did not receive a blood transfusion. These patients also had higher rates of readmission: when Anemia and Blood Transfusions are both present, the readmission rate is 6.46% higher after accounting for case mix index, comorbidities, and complications at the DRG level.
Dr. Edmund K. Waller, MD, PhD, Professor in Hematology, Medical Oncology, Medicine, and Pathology at Emory University School of Medicine in Atlanta, GA, provided commentary on the data. He summarized the data as “showing that [approximately] 25%-30% of admissions include anemia as a diagnosis and about 50% of the patients with anemia receive a transfusion.” He noted that “Typically, patients who receive a transfusion have a more profound anemia than those who do not.”
In regard to the health outcomes, Dr. Waller said it is not surprising that patients with transfusions typically have longer LOS and more frequent readmission. “The transfusion takes about ½ a day, and patients with more profound anemia are usually sicker.”
Dr. Waller also commented on state-level variation. “I am not sure about why there is variation by state. It could be that some states admit less sick patients so that fraction of patients with anemia is less.” He went on to elaborate “however, it appears that there is no strong correlation between the fraction of admissions with anemia, and the fraction of admissions with anemia and transfusion, suggesting that different states may have different transfusion practices.” He also noted that there is no relationship between the fraction of anemic patients who receive transfusions and the total number of admissions by state.