Readmission and mortality outcomes with subsequent follow-up hemoglobin checks in general medical patients with hospital-acquired anemia.

INTRODUCTION

Hospital-acquired anemia is associated with increased readmissions and 30-day mortality. We evaluated whether anemia severity is associated with readmission and mortality 1-year post-hospitalization, and whether a recheck of hemoglobin and/or hematocrit level within 30 days of discharge is associated with reduced readmission and mortality rates.

METHODS

A retrospective cohort study was conducted on 1734 patients at the Mayo Clinic Hospital Inpatient services from 2020 to 2023. The association between readmission and death within 1 year, and hemoglobin recheck within 30 days, or anemic category, was assessed using multivariable Cox regression while controlling for patient characteristics.

RESULTS

There were 1734 patients meeting inclusion criteria (mean age 61.5 years). Prior to discharge, 89.4% of the patients remained anemic, categorized as mild (53%), moderate (39.1%), or severe (7.8%) anemia. Only 526 (30.3%) had a hemoglobin recheck within 30 days of discharge. Anemia severity at discharge was not associated with readmission or mortality. Age, length of stay, and a higher hemoglobin level prior to discharge were significantly associated with readmission and mortality risk. A hemoglobin recheck within 30 days post-discharge was associated with a higher risk of 30-day readmission and subsequent mortality (HR = 5.97, p < 0.001; HR = 1.69, p = 0.006).

CONCLUSION

Patients with more severe hospital-acquired anemia did not have increased readmission and mortality during 1-year post-hospitalization. Anemia rechecking was associated with increased mortality but likely confounded by underlying co-morbidities and other clinical factors. Future studies could compare readmission and mortality in different discharge destinations.