2026 Southeastern Residency Conference

Purpose:
    Hospital-acquired anemia (HAA) is a common complication of hospitalization and is associated with increased length of stay, healthcare costs, readmissions, and mortality. Although anticoagulation therapy carries a known bleeding risk, its role as an independent contributor to HAA has not been well defined. This study evaluated compared the incidence of HAA in non-surgical hospitalized patients receiving prophylactic versus therapeutic anticoagulation.
Methods:
    This retrospective cohort study included adults (≥18 years) hospitalized for more than 4 days who received prophylactic or therapeutic anticoagulation for over 75% of their admission. Prophylactic regimens included subcutaneous heparin, prophylactic-dose enoxaparin, or fondaparinux 2.5 mg daily. Therapeutic anticoagulation included direct oral anticoagulants, intravenous heparin, therapeutic-dose enoxaparin, argatroban, or fondaparinux ≥ 5 mg daily. Patients were required to have hemoglobin measured on admission and within 72 hours of discharge. Exclusion criteria included anemia on admission, surgical procedures (excluding minor/low-risk procedures), therapies affecting hemoglobin, or documented physiologic bleeding.
Results:
    Hospital-acquired anemia occurred in 44.8% of patients receiving prophylactic anticoagulation and 51.3% receiving therapeutic anticoagulation, with no significant difference between groups (p = 0.28). No differences were observed in anemia severity, absolute hemoglobin change (p = 0.93), or rate of hemoglobin decline (p = 0.74).
Conclusion:
    Hospital-acquired anemia was common in non-surgical hospitalized patients, with no significant differences between prophylactic and therapeutic anticoagulation. Anticoagulation intensity alone may not be a primary contributor to HAA.