Stefani Panayiotou (Greece)
General and Oncology Hospital of Kifissia “Agioi Anargyroi”, Athens. 2nd Department of Internal MedicineAuthor of 1 Presentation
SEVERE ANEMIA: IS THE VALUE OR TIME THAT MATTERS?
Abstract
Background and Aims
Severe anemia is a common problem at the emergency department. Aim was to assess the severity of anemia according to its level and duration, in terms of development of ischemic electrocardiographic (ECG) changes and hemodynamic instability.
Methods
In 115 patients (58.3% women), mean age 77.7±11.4 (Μ±1SD) with hematocrit value≤24% or hemoglobin value ≤8 g/dl, hematocrit and hemoglobin levels, ECG abnormalities compatible with anemia, medical history, medications, and reason of admission were recorded. Chi-square and Man-Whitney U tests were used to compare categorical and continuous data respectively.
Results
75 patients (65.2%) had hemoglobin value≤6.5 g/dl and 19 patients (16.5%) suffered from acute anemia. When we compared the patients according to the level of anemia, we found no statistically significant differences between the two groups in terms of the presence of ECG changes or hemodynamic instability. When we compared the patients according to the anemia duration, we found that patients with acute anemia were more likely to have lowest systolic (U=548.5, p=0,006), diastolic (U=546.5, p=0,009) and mean pressure (U=541, p=0,005) and T wave abnormalities (χ2=5086, p=0,024), while ST segment depression has a marginal trend toward significance (χ2=3.558, p=0,059). Concerning heart rate, patients with acute anemia had higher mean heart rate (87.8/min vs 83.8/min), but this difference didn’t reach statistical significance. This result was not statistically significant even when we excluded from the analysis those receiving medication with bradycardic effect.
Conclusions
Although the value of the anemia looks more impressive, its duration (acute or chronic) is what determines the severity.