TERTIARY CARE HOSPITAL REALITY CHECK: HEMOGLOBIN CHANGE AFTER TRANSFUSING 1 UNIT OF FRESH WHOLE BLOOD IN A CROSS-SECTIONAL STUDY

Abstract

Background: Anemia is a typical clinical disorder which often necessitates blood transfusion, especially in hospitalized patients. Even though it is usually believed that the transfusion of a unit of blood raises the hemoglobin levels about 1 g/dL, the response of hemoglobin can differ according to the patient traits and clinical conditions. However, limited evidence exists regarding the real-world hemoglobin increment after transfusion of fresh whole blood in tertiary care settings and the influence of comorbidities on this response.

Objective: To determine the change in hemoglobin level following transfusion of one unit of fresh whole blood (450 mL) in anemic patients and to assess whether comorbid conditions influence the hemoglobin response.

Material and Methods: This cross-sectional study was conducted in the Department of Medicine, Benazir Bhutto Shaheed Teaching Hospital (DHQ), Abbottabad, Pakistan, from 15 April 2024 to 14 April 2025. A total of 159 hemodynamically stable anemic patients (hemoglobin <11 g/dL) receiving one unit of fresh whole blood were included after informed consent. Pre-transfusion (HBBT) and 24-hour post-transfusion (HBAT) hemoglobin levels were measured using the Sahli method. Data on demographics, anemia type, comorbidities, and clinical features were collected. Analysis included descriptive statistics, subgroup comparisons, and multivariable linear regression (SPSS v22).

Results: Mean age was 42.23 ±19.74 years; 62.9% were female. Microcytic anemia was most common (???)54.1%. The mean increase in hemoglobin was 1.65 ± 0.70 g/dL (mean percentage change: 32.29 ± 25.80%), which was a statistically significant improvement after transfusion of fresh whole blood. Females showed greater increase than males. Patients with vague bleeding had lower increment (1.49±0.63 g/dL vs 1.71±0.71 g/dL in non-bleeding). Regression analysis identified female gender as a positive predictor (B = 0.24, p = 0.047) and vague bleeding as a negative predictor (B= −0.29, p = 0.024) of hemoglobin change.

Conclusion: One unit of fresh whole blood transfusion produced a clinically meaningful hemoglobin rise of approximately 1.65 g/dL in anemic patients. Female gender enhanced response, while vague bleeding attenuated it. Comorbidities like hypertension, diabetes, and chronic kidney disease showed no significant impact.