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PubMed1998

A pilot randomized trial comparing symptomatic vs. hemoglobin-level-driven red blood cell transfusions following hip fracture.

BACKGROUND: The indications for transfusion have never been evaluated in an adequately sized clinical trial. A pilot study was conducted to plan larger clinical trials. STUDY DESIGN AND METHODS: Hip fracture patients undergoing surgical repair who had postoperative hemoglobin levels less than 10 g per dL were randomly assigned to receive 1) symptomatic transfusion: that is, transfusion for symptoms of anemia or for a hemoglobin level that dropped below 8 g per dL or 2) threshold transfusion: that is, patients receive 1 unit of packed RBCs at the time of random assignment and as much blood as necessary to keep the hemoglobin level above 10 g per dL. Outcomes were 60-day mortality, morbidity, functional status, and place of residence. RESULTS: Among 84 eligible patients enrolled, mean (+/- SD) prerandomization hemoglobin was 9.1 (+/- 0.6) g/ dL. The median number of units transfused in the threshold transfusion group was 2 (interquartile range, = 1-2), and that in the symptomatic transfusion group was 0 (6; interquartile range, = 0-2) (p < 0.001). Mean hemoglobin levels were approximately 1 g per dL higher in the threshold group than in the symptomatic group: for example, on Day 2, 10.3 (+/- 0.9) g per dL versus 9.3 (+/- 1.2) g per dL, respectively (p < 0.001). At 60 days, death or inability to walk across the room without assistance occurred in 16 (39.0%) of the symptomatic transfusion group and 19 (45.2%) of the threshold transfusion group. Death occurred by 60 days in 5 (11.9%) of the symptomatic transfusion group and 2 (4.8%) in the threshold transfusion group (relative risk = 2.5; 95% CI, 0.5-12.2). Other outcomes were similar for the two groups. CONCLUSIONS: Symptomatic transfusion may be an effective blood-sparing protocol associated with the transfusion of appreciably fewer units of RBCs and lower mean hemoglobin levels than are associated with the threshold transfusion policy. However, it is unknown whether these two clinical strategies have comparable mortality, morbidity, or functional status. A definitive trial is needed.

Adult↗
PubMed2004

Blood management for patients with hemoglobin level lower than 130 g/l in total knee arthroplasty.

INTRODUCTION: The risk of requiring allogeneic blood transfusion after total knee arthroplasty has been recently decreased with several methods such as blood donation, blood salvage, and hematinic. For patients with a low baseline hemoglobin level, however, the rate of allogeneic transfusion is still high, and an effective method for avoiding allogeneic blood transfusion has not been established. We introduced intra- and postoperative blood salvage with the Cell Saver for patients with a baseline hemoglobin level lower than 130 g/l and analyzed the frequency of allogeneic blood transfusion. MATERIALS AND METHODS: From 1993 to 1997, 218 consecutive total knee arthroplasties were performed, and 155 knees with baseline hemoglobin lower than 130 g/l were included in this study. Baseline hemoglobin ranged from 62 to 129 g/l, with a mean of 110 g/l. All patients were managed with intra- and postoperative blood salvage with the Cell Saver. Preoperative autologous blood donation and/or use of hematinic was performed for 129 knees (group 1) and was not performed for 26 knees (group 2). There were no significant differences between the two groups with regard to preoperative factors. To examine the role of perioperative factors (age, sex, baseline hemoglobin level, revision procedure, preoperative blood donation, and use of hematinic) in determining the requirements for allogeneic transfusion, backward elimination logistic regression analysis was used. RESULTS: Seven knees (4.5%) required allogeneic transfusion. Group 1 (2.3%) exhibited a lower rate of allogeneic blood transfusion than group 2 (15.4%) (p=0.016). Hemoglobin levels on the day (p=0.016), 1 week (p=0.0001), and 2 weeks (p=0.007) after surgery were lower in group 1 than in group 2. Backward elimination logistic regression analysis showed that preoperative blood donation (p=0.048) and use of hematinic (p=0.040) were significantly associated with a requirement for allogeneic blood transfusion. CONCLUSION: Preoperative blood donation and use of hematinic were associated with a low incidence of allogeneic blood transfusion after total knee arthloplasty with intra- and postoperative blood salvage, even for patients with a baseline hemoglobin level below 130 g/l.

Aged↗
PubMed2004

Association of hemoglobin level with survival in cervical carcinoma patients treated with concurrent cisplatin and radiotherapy: a Gynecologic Oncology Group Study.

OBJECTIVES: To determine if there is an association of hemoglobin level before or during concurrent cisplatin and radiotherapy (RT) with disease outcome in women with locally advanced cervical cancer, and to assess if the association is particularly significant at a specific interval or time during treatment. METHODS: A retrospective review of 494 patients treated on two consecutive prospective Gynecologic Oncology Group (GOG) trials was conducted. Demographic data, pathologic information, treatment-related factors, and hemoglobin values at baseline and during each week of therapy were collected. Cox proportional hazards model was performed to evaluate the impact of hemoglobin level on progression-free survival (PFS). RESULTS: Of the combined patients, 278 (56%) and 216 (44%) were diagnosed with Stage II and Stage III/IV disease, respectively. Controlling for age, race, performance status, disease stage, tumor size, cell type, and duration of radiotherapy, mean hemoglobin values during treatment were predictive of disease progression (P < 0.0001). The pretreatment level was not significant when hemoglobin levels during treatment were included in the multivariate analysis. When the 6-week treatment course was divided into 2-week periods (early, middle, and late), analysis revealed hemoglobin values during the late period were the most predictive of disease progression (P = 0.0289). CONCLUSIONS: Hemoglobin levels during combined radiotherapy and cisplatin were independent predictors of treatment outcome in advanced cervical carcinoma. The pretreatment level was not a significant predictor of outcome when hemoglobin levels during treatment were included in the multivariate regression model. Levels in the last part of treatment were the most predictive of disease recurrence and survival.

Antineoplastic Agents↗
PubMed2005

Effects of radiation on the longitudinal trends of hemoglobin levels in the Japanese atomic bomb survivors.

The late effects of radiation on the hematopoietic system have not been fully evaluated. We examined the long-term effects of radiation exposure on hemoglobin levels in the Japanese atomic bomb survivors over a 40-year period from 1958 to 1998. Compared to the unexposed survivors, the mean hemoglobin levels for those exposed to a bone marrow dose of 1 Gy were significantly reduced by 0.10 g/dl (95% CI: 0.04 to 0.16) or 0.67% at 40 years of age (P < 0.0001) and by 0.24 g/dl (95% CI: 0.08 to 0.40) or 1.8% at 80 years of age. Radiation effects are greater for smokers than for nonsmokers at age less than 35 years (P < 0.01), although cigarette smoking was associated with increased hemoglobin levels. Sex and birth cohort differences in radiation effects were not found after adjusting for smoking. The radiation-induced reduction in hemoglobin levels could not be explained by the presence of certain anemia-associated diseases.

Adult↗
PubMed1993

Effect of postoperative reinfusion systems on hemoglobin levels in primary total hip and total knee arthroplasties. A prospective randomized study.

A prospective randomized study was undertaken to quantify the effect of reinfusion of postoperative shed blood drainage on the hemoglobin levels in patients undergoing elective primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). One hundred eleven patients were enrolled between December 1990 and August 1991. There were 42 THAs and 69 TKAs. The study group consisted of 57 patients (35 TKAs and 22 THAs) who received a CBC ConstaVac (Stryker Surgical, Kalamazoo, MI) reinfusion system. The control group consisted of 54 patients (34 TKAs and 20 THAs) who received a ConstaVac collection unit. Postoperative drainage volumes were recorded for both groups. In addition, the volume of reinfused blood was recorded for the study group. Postoperative hemoglobins were recorded on postoperative days 1, 3, and 6, the latter reflecting the discharge hemoglobin level. All patients were encouraged to predeposit two units of autologous blood for both THAs and TKAs. This study showed no statistically significant difference in the postoperative hemoglobin levels between the study and control groups at anytime. Additionally, there was no statistically significant difference between hemoglobin levels and drainage volumes in both the THA and TKA study groups, compared to their respective control groups. The results of this study suggest that reinfusion units are not necessary in THAs and TKAs as a matter of routine use.

Aged↗
PubMed1990

Associations of early childhood infections and reduced hemoglobin levels in a historic cohort of Alaska Native infants.

A retrospective study was carried out to determine the effect of common childhood infectious diseases on the hemoglobin level of a cohort of Alaskan Eskimo children born between 1960 and 1962. Hemoglobin and health records were available on 308 children between 6-11 and 12-17 months of age. Additional records were available on 187 of these children at 18-23 months of age. Episodes of chickenpox, measles, pertussis, and lower respiratory infections were reviewed. Between 38 and 50% of infants between 6 and 23 months of age had hemoglobin levels below 11.0 g/dl. The mean hemoglobin level of infants 6-11 and 12-17 months of age decreased with increasing number of total infectious episodes occurring within the 3 months before hemoglobin measurement. This trend was not apparent for infants in the 18-23 months age interval nor were low hemoglobins predictive of illness during the 3 months after the hemoglobin determination. At the 6-11 and 12-17 month age interval the number of lower respiratory infectious were most significantly associated with a decreased hemoglobin value. These observations are consistent with more recent reports that document iron deficiency anemia among children with antecedent infections and again emphasize the role of infection in the development and maintenance of anemia in children about 1 year of age.

Alaska↗
PubMed2004

Concurrent low-dose cisplatin and thoracic radiotherapy in patients with inoperable stage III non-small cell lung cancer: a phase II trial with special reference to the hemoglobin level as prognostic parameter.

PURPOSE: To evaluate the efficacy of concurrent radiochemotherapy in patients with stage III non-small cell lung cancer (NSCLC), and to examine the effect of hemoglobin levels on survival of those patients. The negative impact of anemia on survival has been noticed for other cancer sites including the head and neck, and the uterine cervix, but it has been rarely described in NSCLC cancer patients treated with radiotherapy. METHODS: From April 1995 through March 2002, 56 patients with inoperable stage III non-small lung cancer were treated with radiotherapy consisting of 60 Gy (50 Gy+10 Gy boost) given in 30 fractions of 2 Gy daily, 5 days a week, over a period of 6 weeks, and concurrent low-dose daily chemotherapy (CHT) consisting of 6 mg/m(2) of cisplatin given Mondays-Fridays during weeks 1-2 and 5-6. All patients had stage III disease and ages ranged from 39 to 81 years old (median 63.9 years). RESULTS: The 2-year and 3-year survival rates were 34% and 16%, respectively. Patients with a pretreatment hemoglobin level superior or equal to 11.6 g/dl had a 2-year survival rate of 52% as compared to 15.5% for patients with a pretreatment hemoglobin level inferior to 11.6 g/dl (p=0.0075). Patients with higher KI (>70%) showed better survival rates than those with lower KI. Surprisingly, patients in stage IIIA did not survive significantly longer than those in stage IIIB. Hematological toxicity (grade > or =2) prevailed (25%), followed by esophageal (5.4%) and bronchopulmonary (2%) toxicity. Only three patients experienced acute grade 3 hematological toxicity. Because of acute toxic effects, irradiation was interrupted in 8 patients (14.3%) for 7-13 days (median 7.5 days). Late high-grade (> or =3) toxicity was not found. No grade 4 toxicity or treatment-related deaths were observed during this study. CONCLUSION: Our data show that concurrent radiotherapy with daily low dose cisplatin is well tolerated, and shows survival rates comparable to more aggressive treatment regimens. A combination of this chemotherapy with accelerated hyperfractionated radiotherapy might improve the results in the future. Furthermore, we could show that the hemoglobin levels prior to therapy have an influence on the prognosis, where lower levels were associated with worse outcome. Further trials should consider supplementation with erythropoietin.

Aged↗
PubMed1986

[Hemoglobin level--a prognostic factor of the effectiveness of metronidazole in radiotherapy of cancer of the cervix uteri].

A clinical trial was performed in 339 patients with Stages IIB, IIIB cervical carcinoma to test the effect of radiotherapy in combination with metronidazole. When the overall material was evaluated, no significant difference in the local clearance rate of tumors in metronidazole-treated and untreated patients was revealed. However, when the case material was subdivided into a group of anemic patients (hemoglobin less than 120 g/l) and a group of patients with normal hemoglobin levels (hemoglobin greater than 120 g/l) the data indicated that metronidazole therapy improved significantly the results in the anemic patients. The results in the non-anemic patients were not influenced, to any significant extent, by the drug.

Anemia↗
PubMed1992

Anemia and hemoglobin levels in older persons: relationship with age, gender, and health status.

OBJECTIVE: To determine the relationship of hemoglobin levels and anemia with age and health status in older adults. DESIGN: Survey. SETTING: Community. PARTICIPANTS AND METHODS: Hematologic tests were obtained from 3,946 adults aged greater than or equal to 71 years in three communities (East Boston, MA; Iowa and Washington counties, IA; and New Haven, CT). RESULTS: Hemoglobin level was inversely associated with age, although this was more pronounced in men than in women. The proportion anemic was equal for men and women aged 71-74 years (8.6%) and increased differentially with age, reaching 41% and 21% for men and women aged greater than or equal to 90 years, respectively. Hemoglobin and anemia were independently associated with age, race, body-mass index, smoking, cancer, hospitalization, renal insufficiency, and hypoalbuminemia. The adjusted relative odds of anemia for a 5-year increase in age was 1.5 (95% confidence interval [CI] 1.3-1.8) for men and 1.2 (95% CI 1.1-1.4) for women. CONCLUSIONS: Age is significantly associated with both hemoglobin levels and anemia, with a stronger effect in men compared with women, even after simultaneously adjusting for demographic characteristics and health status. The decline of hemoglobin and concomitant increased anemia with age is not necessarily a result of "normal aging" so the detection of anemia in an older person should prompt appropriate clinical attention.

Activities of Daily Living↗
PubMed2005

The effect of gastrointestinal parasitism on blood copper and hemoglobin levels in sheep.

Endoparasitism is a problem in Trinidad, as it is in most tropical countries. Parasite infection has been suspected to contribute to the pathogenesis of swayback disease (which is also prevalent in Trinidad), but the mode of action has not been clearly defined, although it has been suggested that parasites interfere with the absorption of copper from the gastrointestinal tract. The objectives of the study were to assess the effect of endoparasitism on blood copper levels and hemoglobin (Hb) concentration in sheep in Trinidad. Copper was administered intramuscularly to parasite infected and noninfected animals. The results showed that parasitism has a depressing effect on blood copper and Hb levels, even when administered parenterally. It is concluded that parasitism can aggravate existing hypocupremia and possibly influence the expression of swayback disease.

Animals↗
PubMed2006

Once-weekly epoetin-beta improves hemoglobin levels in cancer patients with chemotherapy-induced anemia: A randomized, double-blind, dose-finding study.

OBJECTIVE: To determine a recommended dose of once-weekly epoetin-beta administration for anemic cancer patients receiving myelosuppressive chemotherapy, we conducted a multicenter, randomized, double-blind trial. METHODS: A total of 86 patients with malignant lymphoma or lung cancer who received chemotherapy containing platinum, taxanes or anthracyclines were enrolled in the study. Patients were randomly assigned into groups that received three dose levels of epoetin-beta (9000, 18,000 or 36,000 IU) administered subcutaneously once a week for 12 weeks. The primary endpoint was change in hemoglobin, while the secondary endpoints were quality of life (QOL) assessed by Functional Assessment of Cancer Therapy-Anemia (FACT-An) questionnaire and transfusion requirements. RESULTS: Among the 69 patients (per protocol set population) assessable for efficacy, hemoglobin level change in the 36,000 IU group was significantly greater than that in the 9000 IU group (1.75 +/- 2.15 versus 0.04 +/- 1.98 g/dl; P = 0.009), and a significant dose-response relationship was observed for the change in hemoglobin level (P = 0.003). Although changes in FACT-An Total Fatigue subscale (Fatigue subscale) scores were similar for the three dosage groups, there was a statistically significant correlation (r = 0.435, P < 0.001) between the change in hemoglobin levels and the change in Fatigue subscale scores. The proportion of transfused patients was significantly smaller in the 36 000 IU group compared with that in the 9000 IU group (P = 0.022, not adjusted for pre-study transfusions). The incidence of adverse events was similar in the three dosage groups. CONCLUSIONS: Once-weekly epoetin-beta 36,000 IU for 12 weeks was well tolerated and significantly increased hemoglobin levels in anemic cancer patients receiving chemotherapy.

Adult↗
PubMed2004

Adult hemoglobin levels at birth and risk of sudden infant death syndrome.

BACKGROUND: During the final weeks of gestation, infants normally begin a transition from the production of fetal to adult hemoglobin. Delayed or faulty transition to the production of adult hemoglobin might play a role in the etiology of sudden infant death syndrome (SIDS). OBJECTIVE: To examine the association between adult hemoglobin levels measured at birth and the subsequent risk of SIDS. DESIGN AND SETTING: Cohort study of all infants born in California between March 1, 1990, and December 31, 1997, who were enrolled in the state's Newborn Screening Program and followed up during the first year of life to identify deaths attributed to SIDS. PARTICIPANTS: Population-based sample of 3.2 million infants. MAIN OUTCOME MEASURE: Risk of death attributed to SIDS. RESULTS: The study included 2425 infants whose deaths were attributed to SIDS. There was an inverse relationship between adult hemoglobin level, expressed as a percentage of total hemoglobin, and the subsequent incidence of SIDS. After adjustment for infant sex, race/ethnicity, length of gestation, maternal age, maternal education, maternal smoking, intrauterine growth restriction, and preeclampsia/eclampsia, the relative risks of SIDS for infants in the lower 4 quintiles of adult hemoglobin level were, in descending order, 1.12 (95% confidence interval [CI], 0.96-1.32), 1.38 (95% CI, 1.19-1.59), 1.55 (95% CI, 1.34-1.80), and 2.15 (95% CI, 1.87-2.47) compared with infants in the highest quintile. CONCLUSIONS: These findings suggest that infants with low levels of adult hemoglobin in the first hours after birth are at elevated risk of SIDS. Delayed maturation in production of adult hemoglobin may play a role in the etiology of some SIDS cases.

California↗
PubMed1984

Clinical value of glycosylated serum protein and glycosylated hemoglobin levels in the diagnosis of gestational diabetes mellitus.

Glycosylated serum protein and glycosylated hemoglobin levels were compared to the oral glucose tolerance test to determine their relative sensitivity in identifying women with gestational diabetes mellitus. The mean glycosylated serum protein level (0.49 +/- SD 0.07 nmol hydroxymethylfurfural per milligram protein) of 17 pregnant women with normal glucose tolerance and the mean value (0.54 +/- SD 0.06 nmol hydroxymethylfurfural per milligram protein) of eight pregnant women with gestational diabetes mellitus were statistically different (P less than .05). However, there was such an overlap between these groups that individuals could not be categorized as normal or as having gestational diabetes mellitus on the basis of the glycosylated serum protein level. There was no difference in glycosylated hemoglobin levels between 41 women with normal glucose tolerance and 12 women with gestational diabetes mellitus. This study concluded that glycosylated serum protein and glycosylated hemoglobin determinations are not as sensitive as the glucose tolerance test in detecting gestational diabetes mellitus as it is now defined.

Blood Glucose↗
PubMed2004

Hemoglobin levels and erythropoietin doses in hemodialysis and peritoneal dialysis patients in the United States.

Erythropoietic agents, a cornerstone of management, are a major component of the cost of renal replacement therapy. The objectives of this study were to compare (on a month-by-month basis) U.S. hemodialysis and peritoneal dialysis patients in terms of the proportion of patients receiving erythropoietin, erythropoietin doses, and hemoglobin levels after initiation of erythropoietin. Patients studied (hemodialysis, n = 121,970; peritoneal dialysis, n = 7129) began dialysis between 1995 and 2000, had Medicare as their primary payer, were 65 yr old or older at dialysis inception, had no erythropoietin claims before dialysis inception, and did not have a switch in dialysis modality in the first 6 mo of dialysis therapy. Total monthly erythropoietin doses and average monthly hemoglobin levels were calculated from Medicare claims. The proportion of patients who received erythropoietin plateaued at 3 mo in both groups: 25% in peritoneal dialysis patients and 80% in hemodialysis patients. However, monthly erythropoietin doses plateaued at 30,000 units in peritoneal dialysis patients and 60,000 units in hemodialysis patients, a disparity not explicable by differences in baseline characteristics. Among subjects who received erythropoietin, mean hemoglobin levels were similar at steady state in both populations and met the National Kidney Foundation Dialysis Outcomes Quality Initiative hemoglobin target level of 11 to 12 g/dl. Hemoglobin levels in U.S. hemodialysis and peritoneal populations are similar. However, erythropoietin doses are dramatically higher in hemodialysis patients.

Aged↗
PubMed2005

Pre-chemotherapy hemoglobin levels and survival in patients with advanced epithelial ovarian cancer who received a first-line taxane/platinum-based regimen: results of a multicenter retrospective Italian study.

OBJECTIVE: The aim of this retrospective multicenter study was to assess whether the pre-chemotherapy hemoglobin levels have any impact on the clinical outcome of patients with advanced epithelial ovarian cancer who received a first-line taxane/platinum-based regimen. METHODS: The study was conducted on 315 patients who underwent initial surgery followed by taxane/platinum-based chemotherapy for FIGO stage IIc-IV epithelial ovarian cancer. All the patients had ECOG performance status 0-1 at presentation. The median follow-up of survivors was 36 months (range, 6-120 months). RESULTS: The 25%, 50%, and 75% quantiles of hemoglobin levels before starting first-line chemotherapy were 10.2, 11.4, and 12.3 g/dl, respectively. Residual disease after initial surgery (>1 cm versus </= 1 cm, P = 0.0013) was the only independent prognostic variable for overall survival. Conversely, hemoglobin levels (<10.2 g/dl versus 10.2-11.4 g/dl versus 11.5-12.3 g/dl versus >12.3 g/dl) were inversely related to overall survival at univariate (P = 0.03) but not at multivariate analysis. CONCLUSIONS: This investigation showed that hemoglobin levels before starting first-line taxane/platinum-based chemotherapy are not an independent prognostic factor for overall survival in patients with advanced epithelial ovarian cancer.

Adult↗
PubMed2003

The effect of erythropoietin therapy and hemoglobin levels on the immune response to Engerix-B vaccination in chronic kidney disease.

BACKGROUND: Patients undergoing chronic hemodialysis have an increased risk of acquiring hepatitis B infection. Only 43-66% of dialysis patients develop effective anti-HBs titers after vaccination. AIM: To evaluate the effect of recombinant erythropoietin (rEPO) therapy and basal hemoglobin levels on the outcome of the immune response to four doses of IM 40 microg Engerix-B vaccination in hemodialysis and chronic kidney disease (CKD) patients before starting replacement therapy. SUBJECTS AND METHODS: One hundred and three patients were included in the study: 34 hemodialysis patients treated with rEPO (Group A), 36 predialytic patients who did not treated with rEPO (Group B) and 33 predialytic patients treated with rEPO (Group C). Plasma creatinine in predialytic patients was 2-7 mg/dL. All patients' HBsAg and anti-HBs antibodies were negative. Patients were immunized with IM 40 microg Engerix-B at 0, 1, 3, and 6 months. Anti-HBs titers were measured at 7th month. RESULTS: Eighty seven point one percent of patients from group C developed protective anti-HBs titers compared with 69.4% from group B and 44.1% from group A (p = 0.001). Patients from all groups with baseline hemoglobin levels above 11 gr/dL developed protective anti-HBs titers significantly more than patients with baseline hemoglobin levels below 11 gr/dL (p < 0.05). CONCLUSION: Predialytic patients treated with rEPO and with hemoglobin levels higher than 11 gr/dL had significantly better immune response outcomes to Engerix-B vaccination. Immunization against hepatitis B infection should be considered at early stages of CKD prior to the deterioration in kidney functions and the development of renal anemia.

Aged↗
PubMed1995

Low-dose acetylsalicylic acid use and hemoglobin levels. Effects in a primary care population.

OBJECTIVE: To determine the prevalence of acetylsalicylic acid therapy and effect of the drug on hemoglobin concentration over time. DESIGN: Retrospective, observational study. SETTING: Primary care population in a university-affiliated family medicine clinic. PATIENTS: A population-based sample of 80 patients receiving low-dose ASA for secondary prevention of cardiovascular disease was studied. Of 84 patients receiving the drug after a cardiovascular problem, four were excluded: one man died of a recurrent stroke during the study; the file of a second man was unavailable; another man developed a bleeding ulcer; and one woman had been taking ASA for only 1 month when the data were collated. MAIN OUTCOME MEASURES: Demographic variables of patients taking low-dose ASA, duration of ASA use, and two successive measures of hemoglobin level. RESULTS: The frequency of ASA administration was 7.7% for men aged 60 and older and 2.9% for women. Women had no significant change in hemoglobin levels, while men had a mean loss of 0.472 g/dL (95% confidence interval, .198 to .746; P = .009). For the study population as a whole (80 patients), the average decline was 0.294 g/dL (95% confidence interval, .039 to .549; P = .029). CONCLUSIONS: Although the clinical significance of these findings is uncertain, they suggest the need for a prospective investigation of the influence of low-dose ASA on hemoglobin levels.

Adult↗