title: Hemoglobin levels and blood transfusion in patients with sepsis in Internal Medicine Departments.
abstract: Acute reduction in hemoglobin levels is frequently seen during sepsis. Previous studies have focused on the management of anemia in patients with septic shock admitted to intensive care units (ICU's), including aggressive blood transfusion aiming to enhance tissue oxygenation.
  
  
  
  To study the changes in hemoglobin concentrations during the first week of sepsis in the setting of Internal Medicine (IM) units, and their correlation to survival.
  
  
  
  Observational prospective study.
  
  
  
  We recorded hemoglobin values upon admission and throughout the first week of hospital stay in a consecutive cohort of septic patients admitted to IM units at a community hospital, the patients were enrolled into a prospective registry. Data on blood transfusions was also collected, we examined the correlation between hemoglobin concentrations during the first week of sepsis and survival, the effect of blood transfusion was also assessed.
  
  
  
  Eight hundred and fifteen patients (815) with sepsis were enrolled between February 2008 to January 2009. More than 20 % of them had hemoglobin levels less than 10g/dL on admission, a rate that was doubled during the first week of sepsis. Overall, 68 (8.3 %) received blood transfusions, 14 of them (20.6 %) due to bleeding. Typically, blood transfusion was given to older patients with a higher rate of malignancy and lower hemoglobin levels. While hemoglobin concentration on admission had strong correlation with in-hospital mortality (O.R-0.83 [95 % C.I. 0.74-0.92], blood transfusion was not found to be an independent predicting factor for mortality.
  
  
  
  Anemia is very common in sepsis. While hemoglobin level on admission exhibit independent correlation with survival, blood transfusion do not.
authors.affiliation: Internal Medicine Department, Carmel Medical Center, Michal 7, 34362, Haifa, Israel. gassan_muady1@hotmail.com.
authors.forename: Gassan Fuad
authors.initials: GF
authors.lastname: Muady
authors.affiliation: Internal Medicine Department, Carmel Medical Center, Michal 7, 34362, Haifa, Israel.|The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Bitterman
authors.affiliation: Internal Medicine Department, Carmel Medical Center, Michal 7, 34362, Haifa, Israel.
authors.forename: Arie
authors.initials: A
authors.lastname: Laor
authors.affiliation: Harvard Clinical Research Institute, Boston, MA, USA.|School of Public Health, Boston University, Boston, MA, USA.
authors.forename: Moshe
authors.initials: M
authors.lastname: Vardi
authors.affiliation: Internal Medicine Department, Carmel Medical Center, Michal 7, 34362, Haifa, Israel.
authors.forename: Vitally
authors.initials: V
authors.lastname: Urin
authors.affiliation: Infectious Diseases Unit, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Nesrin
authors.initials: N
authors.lastname: Ghanem-Zoubi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000401:mortality / Q000628:therapy; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006748:Hospital Departments; D017052:Hospital Mortality; D006801:Humans; D007388:Internal Medicine; D007557:Israel / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D012772:Shock, Septic / Q000097:blood / Q000401:mortality / Q000628:therapy
chemical_list: D006454:Hemoglobins
keywords: Anemia; Blood transfusion; Hemoglobin; Internal medicine units; Sepsis