Practice trends in the management of low hematocrit in the acute rehabilitation setting

Objective: To examine current clinical practice regarding the management of anemic patients in the acute rehabilitation setting. Design: Ninety-four medical directors of inpatient rehabilitation units wer e surveyed on their use of transfusion thresholds and human recombinant ery thropoietin. Factors affecting their clinical decision making were assessed . Results: The majority of physicians responded that they recommend red cell transfusion in patients with a hematocrit < 25%. When a history of cardiova scular disease and advanced age was present, more physicians were likely to transfuse at higher hematocrit levels. Forty-six percent of physicians rep orted recommending the use of human recombinant erythropoietin in anemic pa tients. Only 30% of respondents classified their clinical management of ane mia as evidence based. Conclusions: Clinical practice guidelines should be developed to aid the re habilitation medicine specialist in the management of anemic patients in th e acute rehabilitation setting. Further study of the relationship between h ematocrit level, tolerance for therapeutic exercise, and long-term function al outcome is indicated.