KUMJ | VOL. 23 | NO. 3 | ISSUE 91 | JULY-SEPTEMBER, 2025

Clinical Characteristics and Outcomes of Anemia in Critically Ill Patients: A Cross-Sectional Observational Study from a Tertiary Intensive Care Unit in Nepal
Simkhada N, Pathak S, Thapa N, Poudel P, Dhakal B, Upadhyay G, Thapa J, Regmi A, Ojha S, Adhikari S

Abstract:
Background Anemia is a common clinical problem among critically ill patients; however, its prognostic significance remains debatable. In low-resource settings, such as Nepal, data are limited. This study evaluated the clinical, laboratory, and outcome profiles of anemia in a tertiary Intensive Care Unit. Objective To assess the clinical characteristics, laboratory features, and outcomes of anemia in critically ill patients admitted to a tertiary Intensive Care Unit in Nepal. Method This retrospective observational study included 113 adult Intensive Care Unit patients with anemia admitted to Dhulikhel Hospital, Nepal, from October 2024 to March 2025 after obtaining ethical approval from the Institutional Review Committee, Kathmandu University School of Medical Sciences (IRC, KUSMS-156/25). Demographic data, anemia severity, laboratory markers, including peripheral blood smear (PBS), and outcomes, such as mortality and Intensive Care Unit stay, were analyzed using IBM SPSS Statistics version 25.0. Categorical variables were compared with Chi-square tests, continuous variables with independent t-test or Mann- Whitney U test, and correlations were assessed with Spearman’s rank method. Result The median hemoglobin level was 97 g/L (78-112g/L), and mild anemia was the most common (49.5%). Mortality correlated strongly with abnormal peripheral blood smear (p < 0.001, r = 0.52) and moderately with older age (p = 0.012, r = 0.35). Although anemia severity was not statistically significant (p = 0.423), its weak positive correlation (r = 0.15) indicates a potential trend. Conclusion Peripheral blood smear abnormalities and advanced age strongly predict mortality in critically ill patients, while anemia severity alone does not. Routine smear use in resource-limited ICUs may aid early risk stratification and improve care.
Keyword : Anemia, Critical Illness, Intensive care unit, Nepal