Anemia Screening and Treatment

Anemia is a common sign in both inpatient and outpatient settings and is defined as a decrease in the number of circulating red blood cells or hemoglobin. Oftentimes anemia is not evaluated or managed adequately. It is routinely listed as a freestanding diagnosis, however, it is in fact a clinical sign indicating the presence of an underlying etiology and additional workup is required to elucidate its cause. Anemia leads to diminished tissue oxygenation and can worsen the progression of many coexisting diseases. Symptoms of anemia are diverse and can include fatigue, weakness, lightheadedness, headache, pallor or jaundice, tachycardia, palpitations, chest pain, dyspnea, cold distal extremities, and claudication. These signs and symptoms vary in prevalence and magnitude. Anemia causes a decrease in the relative number of circulating red blood cells or hemoglobin, which leads to a consequent decrease in the amount of oxygen delivered to tissues. However, the hemoglobin concentration constituting anemia varies based on factors such as gender, ethnicity, and age. In addition, opinions differ as to which patient populations should undergo routine screening for anemia. Finally, the threshold for initiating treatment and the goals of treatment are subject to variation according to discipline and medical condition