Anemia is a common condition in the geriatric population. Several studies have shown that the prevalence of anemia increases with age, with a notable rise starting at the age of 65 and a significant increase after the age of 80.
To diagnose anemia, physicians heavily rely on the complete blood count (CBC), specifically looking at hemoglobin and hematocrit levels. These levels can be influenced by various factors, including ethnic background, gender, altitude, heavy smoking, and physiological fluctuations in plasma volume. The critical value of hemoglobin plays a crucial role in medical decision-making.
But what exactly is a critical result? According to Dr. George Lundeberg, a critical laboratory result is defined as “a laboratory test result that indicates a pathophysiological state significantly deviating from the normal range to the extent that it could be life-threatening unless prompt action is taken, and for which corrective measures can be implemented.” Determining the critical cutoff value depends on factors such as the patient population, healthcare setting, and feedback from caregivers.
Numerous studies have aimed to establish critical values for common analytes, including hemoglobin. A survey conducted by the College of American Pathologists examined critical values from over 150 laboratories. The majority of these laboratories reported a critical value of <6 mg/dL for hemoglobin.
We, at Aculabs, conducted a study to assess the critical value for hemoglobin across New Jersey (NJ) and Pennsylvania (PA). This study involved 25 hospitals and four major reference laboratories. Our findings revealed that 17 laboratories (56%) had a critical level set at <6.0 g/dL, four laboratories (13.3%) used <6.5 g/dL as their critical value, and nine laboratories (30%) had a critical threshold of <7.0 g/dL. None of the laboratories we surveyed considered values above 7 g/dL as critical.
As a result of our study, Aculabs will be implementing a new critical value for hemoglobin, setting it at 7 g/dL. This change reflects our commitment to patient safety and aligns with the evolving standards in laboratory medicine.