Daily Hemoglobin Measurement Usually Unnecessary in Inpatients

More evidence supporting elimination of “routine” inpatient labs!

For hospitalized patients: repeat hemoglobin testing within a 24-hour period is of little value

Clinical Question:
Is it useful to repeat a hemoglobin test within a single calendar day for a hospitalized patient?

Bottom Line:
In this study, repeat hemoglobin testing within a 24-hour period for hospitalized patients showed a greater than 1 g/dL drop only 13.5% of the time. In other words, almost 90% of the time, there is no clinically significant change in hemoglobin values over the course of a calendar day. This result should be taken into account when considering
repeat testing, especially in patients without any suspicion of bleeding.
Although the percentage of hospital days during which 2 hemoglobin values were obtained and no transfusions were given was small (8%) in this analysis, the potential impact of unnecessary repeat testing—including false positive readings, higher costs, and the potential for hospital-acquired anema—is not negligible. (LOE = 2c)

Reference:
Rajkomar A, McCulloch CE, Fang MC, et al. Low diagnostic utility of rechecking hemoglobins within 24 hours in hospitalized patients. Am J Med 2016;129(11):1194-1197.

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