Choosing Wisely:

Don’t perform repetitive complete blood count and chemistry testing in the face of clinical and lab stability.

Rationale and Comments: Hospitalized patients frequently have considerable volumes of blood drawn (phlebotomy) for diagnostic testing during short periods of time. Phlebotomy is highly associated with changes in hemoglobin and hematocrit levels for patients and can contribute to anemia. This anemia, in turn, may have significant consequences, especially for patients with cardiorespiratory diseases. Additionally, reducing the frequency of daily unnecessary phlebotomy can result in significant cost savings for hospitals.
Sponsoring Organizations:
  • Society of Hospital Medicine (Adult)
  • Sources:
  • Prospective studies
  • Disciplines:
  • Hematologic
  • References: • Adam C, et al. Diagnostic blood loss from phlebotomy and hospital-acquired anemia during acute myocardial infarction. Arch Intern Med. 2011;171(18):1646-53.
    • Thavendiranathan P, et al. Do blood tests cause anemia in hospitalized patients? The effect of diagnostic phlebotomy on hemoglobin and hematocrit levels. J Gen Intern Med. 2005;20(6):520-4.
    • Stuebing EA, et al. Surgical vampires and rising health care expenditure: reducing the cost of daily phlebotomy. Arch Surg. 2011;146(5):524-7.

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