Anemia: Its Impact on Hospitalizations and Length of Hospital Stay in Nursing Home and Community Older Adults

Objective: To examine the association between anemia and its severity on hospitalizations and length of stay (LOS) in hospital in older adults. Participants: A cross-sectional sample of 590 adults from long term care facilities (NH) and community ambulatory care (C) in the Bronx, NY. Measurements: Patient demographics, medical history, hospitalizations during an 18-month period, LOS per hospitalization, and laboratory parameters including hemoglobin (Hb) at enrollment and during hospitalization. Results: Anemia and hospitalization occurred in 62% and 64% of the sample, respectively. NH residents were older (P = .0013), had fewer hospitalizations (P = .001) but similar rates of anemia, anemia severity, gender ratios and LOS per hospitalization as C subjects (all P > .05). Females were older (P = .0455), had fewer hospitalizations (P = .001) and more severe anemia than males (P < .0005). The likelihood of hospitalization increased 1) as anemia severity increased (P < .00005), 2) in African Americans (P = .002), 3) in males (P = .006), and 4) as anemia duration increased (P < .0005). Anemic patients had significantly longer total LOS days than non-anemic individuals (P < .00005); total LOS also increased as severity of anemia increased (P = .0022). Conclusions: Our findings suggest anemia, in particular chronic and severe anemia in older Americans is associated with an increased likelihood of hospitalizations and an increased LOS when hospitalized. The recognition and treatment of anemia in older adults has the potential to reduce hospitalizations and LOS and decrease overall health care costs to individuals and third party providers.