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| Evaluation of hemoglobin monitoring frequency in patients on anticoagulation therapy |
| Liana Ha1, Saira Mirza1, Alyssa E. Utz1, Salman Hasham1, Mikhail Y. Akbashev1,2 1Grady Health System, Atlanta, GA, United States/2Emory University, Atlanta, GA, United States |
Introduction Major bleeding is the most notable risk associated with anticoagulation. Routine hemoglobin screening has been valuable in detecting occult bleeds but there is no clear designation on how often patients on anticoagulation therapy should be monitored and if this affects bleeding risk. The objective of this study was to compare outpatient hemoglobin monitoring intervals of less than and more than annually in patients on anticoagulation therapy. Methods This IRB exempt single-center retrospective chart review included patients over 18 years of age receiving anticoagulation therapy for at least one year from our institution’s outpatient pharmacy between January 2017 – March 2023 with consecutive hemoglobin results with a greater than or equal to 2 g/dL decrease. Results Of 7254 hemoglobin values, 196 were included with an average patient age of 61 years old and the majority African American. One hundred and sixty (82%) had hemoglobin monitored annually or more with a mean hemoglobin difference of -3.17 g/dL, 49 reported bleeding (31%), 20 blood transfusions (13%), and 15 hemoglobin less than 7 g/dL (9%). Thirty-six (18%) had hemoglobin monitored less than annually with a mean hemoglobin difference of -2.78 g/dL, 13 reported bleeding (36%), three blood transfusions (8%), and zero with hemoglobin less than 7 g/dL. Conclusion Patients with a hemoglobin decrease of greater than or equal to 2 g/dL were monitored more frequently than annually and this was associated with a greater likelihood of occult anemia. |