JAMDA
Volume 9, Issue 5 , Pages 354-359, June 2008

Anemia: Its Impact on Hospitalizations and Length of Hospital Stay in Nursing Home and Community Older Adults

This work was presented, in part, at the Annual Meeting of the American Medical Directors Annual Meeting March 29-April 1, 2007: Dharmarajan TS, Pankratov A, Morris E, Jaspal P, Phillips S, Norkus EP. Does the presence of anemia and its severity in nursing home and community residents affect the rate of hospitalization and length of stay in hospital (LOS). J Am Med Dir Assoc 2007;8:B19 and at the Annual American Geriatrics Society Meeting May 2-May 6, 2007: Dharmarajan TS, Pankratov A, Qurashi S, Donepudi I, Morris E, Law G, Phillips S, Jaspal P, Norkus EP. Impact of chronic anemia on hospitalizations and healthcare costs in older adults from nursing homes (NH) and community (C). J Am Geriatr Soc 2007;55:S31.

  • T.S. Dharmarajan, MD, FACP, AGSF

      Affiliations

    • Department of Medicine, Our Lady of Mercy Medical Center, Bronx, NY
    • Division of Geriatrics, Our Lady of Mercy Medical Center, Bronx, NY
    • University Hospital of New York Medical College, Valhalla, NY.
    • Corresponding Author InformationAddress correspondence to T.S. Dharmarajan, MD, 31 Pheasant Run, Scarsdale, NY 10583l.
    • ,
  • Anna Pankratov, MD

      Affiliations

    • Division of Geriatrics, Our Lady of Mercy Medical Center, Bronx, NY
    • University Hospital of New York Medical College, Valhalla, NY.
    • ,
  • Evelyn Morris, MD

      Affiliations

    • Division of Geriatrics, Our Lady of Mercy Medical Center, Bronx, NY
    • University Hospital of New York Medical College, Valhalla, NY.
    • ,
  • Saima Qurashi, MD

      Affiliations

    • Division of Geriatrics, Our Lady of Mercy Medical Center, Bronx, NY
    • University Hospital of New York Medical College, Valhalla, NY.
    • ,
  • Gregory Law, MD

      Affiliations

    • Division of Geriatrics, Our Lady of Mercy Medical Center, Bronx, NY
    • University Hospital of New York Medical College, Valhalla, NY.
    • ,
  • Sunila Phillips, MD

      Affiliations

    • Division of Geriatrics, Our Lady of Mercy Medical Center, Bronx, NY
    • University Hospital of New York Medical College, Valhalla, NY.
    • ,
  • Praveen Jaspal, MD

      Affiliations

    • Department of Medicine, Our Lady of Mercy Medical Center, Bronx, NY
    • University Hospital of New York Medical College, Valhalla, NY.
    • ,
  • Indira Donepudi, MD

      Affiliations

    • Department of Medicine, Our Lady of Mercy Medical Center, Bronx, NY
    • University Hospital of New York Medical College, Valhalla, NY.
    • ,
  • Edward P. Norkus, PhD, FACN

      Affiliations

    • Department of Medical Research, Our Lady of Mercy Medical Center, Bronx, NY
    • University Hospital of New York Medical College, Valhalla, NY.

published online 02 May 2008.

Objective

To examine the association between anemia and its severity on hospitalizations and length of stay (LOS) in hospital in older adults.

Participants

A cross-sectional sample of 590 adults from long term care facilities (NH) and community ambulatory care (C) in the Bronx, NY.

Measurements

Patient demographics, medical history, hospitalizations during an 18-month period, LOS per hospitalization, and laboratory parameters including hemoglobin (Hb) at enrollment and during hospitalization.

Results

Anemia and hospitalization occurred in 62% and 64% of the sample, respectively. NH residents were older (P = .0013), had fewer hospitalizations (P = .001) but similar rates of anemia, anemia severity, gender ratios and LOS per hospitalization as C subjects (all P > .05). Females were older (P = .0455), had fewer hospitalizations (P = .001) and more severe anemia than males (P < .0005). The likelihood of hospitalization increased 1) as anemia severity increased (P < .00005), 2) in African Americans (P = .002), 3) in males (P = .006), and 4) as anemia duration increased (P < .0005). Anemic patients had significantly longer total LOS days than non-anemic individuals (P < .00005); total LOS also increased as severity of anemia increased (P = .0022).

Conclusions

Our findings suggest anemia, in particular chronic and severe anemia in older Americans is associated with an increased likelihood of hospitalizations and an increased LOS when hospitalized. The recognition and treatment of anemia in older adults has the potential to reduce hospitalizations and LOS and decrease overall health care costs to individuals and third party providers.

Keywords: Anemia, severity of anemia, rate of hospitalization in anemia, length of hospitalization in anemia

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 This study was internally funded as part of the Geriatric Medicine Fellowship program.

 The authors have no conflicts of interest pertaining to this article.

PII: S1525-8610(08)00100-X

doi:10.1016/j.jamda.2008.02.008

JAMDA
Volume 9, Issue 5 , Pages 354-359, June 2008

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