Prediction of Outcome in Anemic Critically ill Patients in Intensive Care Unit: A Retrospective Observational Study

Abstract

Objective: Anemia is a universal finding in critically-ill patients which add to the risk of poor outcomes. We aimed to evaluate the prevalence of anemic critically-ill patients and to detect predictors of outcome.   Methods: A retrospective study from 5-year data in the electronic medical record of the critical care department at Cairo University. All medical ICU patients that were admitted with or developed anemia during their ICU stay were included. All data of admission, ICU stay, and APACHE II were recorded and their association with the final outcome was determined.   Results: The study included 301 patients. Anemia was detected in 84.6% of patients. Blood transfusion was given to 61.8% of patients while not given to 38.2% and was not significantly associated with outcome. Non-survivors were 37.5%. Only DM, IHD and CKD were associated with poor outcome (P values 0.045, 0.026, 0.001 respectively). Need for MV or vasopressors was associated with poor outcome (P values 0.0001 for both). WBC, platelets at admission, and Hb at day 14 (P values 0.014, 0.002, 0.0001) respectively. The Multi-variate analysis detected these variables (need for MV, vasopressors, and Hb at the 14 th day ≤7.3 g/dl) could correctly detect outcome with sensitivity 91.6%, specificity 73.6%, PPV 76.7%, and NPV 90.3% and total accuracy 82.4%.   Conclusions: Anemia in critically-ill patients is common and associated with poor outcomes. Blood transfusion was not associated with a better outcome. Combination of MV need and vasopressors with persistent anemia at day 14 were the best predictors of poor outcomes.