Invited Commentary
Oct 10, 2011

Hazards of Hospitalization: More Than Just “Never Events”Comment on “Diagnostic Blood Loss From Phlebotomy and Hospital-Acquired Anemia During Acute Myocardial Infarction”

Author Affiliations

Author Affiliations: Department of Medicine, Division of Hospital Medicine, University of California, San Francisco.

Arch Intern Med. 2011;171(18):1653-1654. doi:10.1001/archinternmed.2011.335

Hospitalization can be a hazardous time for patients. Complications that occur as a result of hospitalization, such as venous thromboembolism, nosocomial infections, and medication errors, result in considerable morbidity and mortality.1 In this issue of Archives, Salisbury et al2 suggest that hospital-acquired anemia (HAA) may be yet one more potentially preventable complication associated with hospitalization. Anemia has been associated with worse clinical outcomes in the setting of acute myocardial infarction (AMI).3 The authors evaluated the association between HAA and blood loss from diagnostic phlebotomy in patients with AMI hospitalized in 57 US hospitals. Increased blood loss from phlebotomy was an independent predictor of HAA. Of particular interest was the finding that the mean phlebotomy volume in patients varied widely across individual hospitals, suggesting that some blood tests may have been simply “routine” and implying that reduction in the variability of care could potentially lead to reductions in HAA.

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