Prevalence of anemia and short-term outcome among internal medicine patients at university teaching Hospital of Kigali ‘‘Prospective observational analytical study’’

Abstract

Background: Anemia is defined by World Health Organization as hemoglobin level of <13.0g/dl in men and <12g/dl in women. Anemia is a big concern worldwide with around 2 billion people affected. It has numerous predisposing factors including Nutritional deficiencies, Infections, Malignancies, Chronic inflammations, chronic kidney disease, etc. Admitted patients with concurrent anemia are at increased morbidity and mortality risk and there is evidence that it prolongs hospital stay and increases re-admission rates. In Rwanda, we know from Rwanda demography and health survey 2015 that the prevalence of anemia is around 36.5% in children and 19.2% in females. Data in high-risk patients like those in hospital with different comorbidities are lacking. Our aim was determining the prevalence of anemia in admitted patients but also their length of hospital stay and mortality risk according to their hemoglobin level.

Method: A Prospective Observational Analytical Study at University Teaching Hospital of Kigali was done and recruited 166 Patients admitted in March and April of 2021; among whom 143 were eligible for the study and followed up until discharge. Results: The Prevalence of anemia was 52.4% among 143 enrolled patients. The majority had Normocytic anemia with 41.9% and macrocytic anemia was the least common with 2.8% of participants. Hypertension and Diabetes were the most common comorbidities found in 50 (35%) and 37 (25.9%) of respondents respectively. CKD (OR 12.108, p0.001), Cancer (OR 10.488; p 0.027) and HIV/AIDS had higher odds of developing anemia. Mortality rate was 13.3 % in all participants but the mean Hemoglobin of patients who died was lower compared to the mean hemoglobin of patients who were discharged alive with 11.4±4.1g/dL and 12±3.3 g/dL respectively (P-value 0.551). Patients with severe anemia were 4 times more likely to die while mild and moderate anemia did not significantly impact the likelihood of death compared to patients with normal Hemoglobin. Hemoglobin level correlates with the length of hospital stay as the lower the hemoglobin level, the longer the hospital stay was (P-value 0.010). Conclusion: Anemia is prevalent among in-patients at CHUK patients with CKD, cancers, and HIV/AIDS as leading predisposing factors. Patients with anemia are at increased risk of mortality and longer length of hospital stay compared to those with normal hemoglobin level.