71 blood draws per hospitalization?

71.5 blood draws per hospitalization? Is that even possible?

A recent study from Yale shows that patients have blood drawn 71.5 times during a typical hospitalization. The researchers were actually looking at when the draws are performed, showing that 39% are done between 4 and 7 a.m.

But what strikes me as incredulous is the sheer quantity. And this excludes critical care patients, and draws done in the ED. These are patients on the floor – pneumonia, COPD, stroke, COVID and the like.

Sure, some patients need daily labs. Sometimes we’re following an acute kidney injury, hyponatremia, or INRs. (Personally, I doubt we need daily INRs on everyone on warfarin, but our pharmacy disagrees.) Sometimes we may “need” more frequent labs, such as in GI bleeding. Perhaps those labs actually benefit patients. Maybe they do, maybe they don’t, but at least we have a justifiable reason when placing the order.

But 71 blood draws during a hospitalization, after the patient leaves the ED? It’s quite possible that the number is higher at Yale than at many other hospitals. They’re a big tertiary care facility after all. But 71?

Would any of us want our blood drawn 71 times during a hospitalization, with 28 of those done before 7 a.m.? Better include a type and cross, since we may need a transfusion; little blood is left in the patient, after all.

Reference: Caraballo et al. JAMA 2023:329;255

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