Inpatient consultations by the hematology department over a 1-year period

Lee, Ha Young; Koh, Sung Ae; Sohn, Se Hoon; Kim, Min Kyoung; Lee, Kyung Hee; Hyun, Myung Soo

Abstract

BACKGROUND/AIMS
Although inpatient hematology consultations have recently increased, the reasons for consultation, as well as the impact of inpatient hematologic consultations, are not clear. Therefore, we assessed patient profiles, the reasons for hematology consultations, and diagnoses at our hospital.
METHODS
We evaluated 177 consecutive patients with hematology problems seen between March 2004 and February 2005. For each, we assessed the reason for the consultation, patient diagnosis, and outcome.
RESULTS
Of 28,854 inpatients in our hospital, 177 (0.6%) required consultations for hematology problems. Of these 177 inpatients, 85 (48%) were male and 92 (52%) were female; their median age was 55 years (range 16-85 years), with the most frequent age group being patients 61-70 years old. Hematology consultations were requested by the neurosurgery (25%), general surgery (11%), internal medicine (10%), neurology (10%), and orthopedics (9%) departments. The most common reasons for consultation were anemia (29%), thrombocytopenia (21%), pancytopenia/bicytopenia (16%), coagulation abnormalities (14%), and thrombocytosis (5%). In one-third of these consultations, the hematologic abnormality was detected after admission and most were resolved successfully. The most common cause of anemia was iron deficiency (43%). Drug-induced thrombocytopenia and pancytopenia were also common (20%), and were thought to be due to anticonvulsants and antibiotics. Bone marrow examination was required in 19 patients (11%). Careful examination detected bleeding of the gastrointestinal tract, or liver or hematologic diseases, such as chronic myeloproliferative disorders, in some of these patients.
CONCLUSIONS
Although it provides a small cross-sectional survey of the types of patient and problems seen by hematologists during in-patient consultations, this information may help to improve patient care and the quality of hematology consultations.