Edita Taparauskienė, Dalia Gervienė, Ieva Česnavičiūtė, Ieva Petraitytė
Objective. To analyze clinical experience of treating severe anemias, find out most common causes of anemia, to assess efficiency of hemotransfusions.Materials and methods. Were examined patients with severe or life threatening anemia and who had undergone hemotransfusion in 2014, in Kaunas Clinical Hospital, the Internal Medicine Diagnostics section. We were guided by the World Health Organizations and the National Cancer Institute recommendations of anemia severity. To assess efficiency of hemotransfusions, we divided subjects to 2 age groups. The red blood cells transfusion was considered to be effective if the number of hemoglobin would increase by at least 10 g/l after a one hemotransfusion period. The qualitative data averages were compared by using a t – test. The difference was considered as statistically significant, p <0.05. Results. Total of 148 patients were surveyed, including 95 (64.2 %) of women and 53 (35.8 %) of men. The mean age of participants was 69.24. 27 participants were younger than 50 (17 women and 10 men), 121 participants were older than 50 (78 women and 43 men). The most common causes of severe anemia: 50 % – acute bleeding, 37.17 % – of related chronic diseases, 12.83 % – of impaired erythropoiesis. There is no statistically significant difference of hemotransfusions performance between men and women (p>0.068), however, hemotransfusion is more effective for both of the age group up to 50 years (p<0.036). After the first red blood cell transfusion, positive dynamics were 54.7 %, after the second – 56.4 %, after the third – 52.4 %, after the fourth – 60 %, after the fifth – 16.7 %, and after the sixth – 50 %. After applying the regression model, it can be assumed that the hemotransfusion can be relatively more effective at a lower initial number of hemoglobin, despite the correlation with the number of transfusions. By assessing severe anemia causes, the hemotransfusions efficiency is unequal (p<0.027). In case of severe anemia due to hypoproductive reason, the efficiency reaches 73.7 %, in the presence of acute bleeding 52.8 %, and by eliminating the cause of illness, the hemotransfusion is effective for 80 % of the patients. In cases of chronic diseases, the efficiency of hemotransfusions is lower – positive dynamics require more than one hemotransfusion (p <0.035). Conclussions. The most common causes of anemia: for half of the patients – acute bleeding, for one third of the patients – related chronic diseases, for the rest – violations of erythropoiesis. Hemotransfusions are effective for both men and women, but faster positive dynamics are observed in the group of younger patients (up to and including 50 years). The hemotransfusion is effective in a case of severe anemia due to malfunctioning erythropoiesis and acute bleeding, but this treatment is less effective in the case of chronic diseases and it is needed more than one hemotransfusion to achieve positive dynamics.
Keyword(s): severe anemia; efficiency of hemotransfusion.
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