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We read with great interest the article by Vanhala et al. [1], in which the authors aimed to investigate the incidence of severe anemia among patients with moderate-to-severe traumatic brain injury. They also evaluated patient-related and trauma-related factors that might be associated with the development of anemia. The authors of the present study mentioned that severe anemia was diagnosed in 66 patients (45.5%), of whom seven (10.6%) had anemia at admission [1]. Although they enlisted the possible exclusion factors, they did not mention the history of hemoglobinopathies. Hemoglobinopathies are a group of inherited blood disorders and diseases that primarily affect red blood cells, which can cause hemolytic anemia [2]. The authors demonstrated the decline in mean hemoglobin (Hb) values during the hospital stay, however, they did not mention the duration of hospital stay. It would be interesting to see whether this fall in Hb values correlated with the hospital stay in their patients. In a previous study, it has been observed that the decline in Hb levels correlates with prolonged intensive care unit stay [3]. It would also be interesting to know how many patients with severe anemia received blood transfusion. The authors should have also commented on how their results were different in terms of hospital stay between the patients who received transfusion and those who did not receive transfusion. Boutin et al. [4], in their multicentric cohort study, have observed that the length of intensive care unit stay and hospital stay were longer in patients with traumatic brain injury who received blood transfusion. We believe that the basic information about blood transfusion in these patients would have provided more useful insights.
References
Vanhala H, Junttila E, Kataja A, Huhtala H, Luostarinen T, Luoto T, et al. Incidence and associated factors of anemia in patients with acute moderate and severe traumatic brain injury. Neurocrit Care. 2022. https://doi.org/10.1007/s12028-022-01561-9.
Poyart C, Wajcman H. Hemolytic anemias due to hemoglobinopathies. Mol Aspects Med. 1996;17:129–42.
Corwin HL, Gettinger A, Pearl RG, Fink MP, Levy MM, Abraham E, et al. The CRIT study: anemia and blood transfusion in the critically ill—current clinical practice in the United States. Crit Care Med. 2004;32:39–52.
Boutin A, Moore L, Lauzier F, Chasse M, English S, Zarychanski R, et al. Transfusion of red blood cells in patients with traumatic brain injuries admitted to Canadian trauma health centres: a multicentre cohort study. BMJ Open. 2017;7: e014472.
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IK: This author prepared the first draft of the article. HP: This author helped in finalizing the article. CM: This author helped in supervising the final article. The final manuscript was approved by all authors.
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Kapoor, I., Prabhakar, H. & Mahajan, C. Letter to the Editor: Incidence and Associated Factors of Anemia in Patients with Acute Moderate and Severe Traumatic Brain Injury. Neurocrit Care 37, 810 (2022). https://doi.org/10.1007/s12028-022-01591-3
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DOI: https://doi.org/10.1007/s12028-022-01591-3