Virk et al evaluated patients with spur cell hemolytic anemia (SCHA) associated with end-stage liver disease. They identified factors associated with 90-day mortality. The authors are from Harvard Medical School, University of California Los Angeles, Veterans Affairs Greater Los Angeles Healthcare System and Massachusetts General Hospital.
Patient selection: SCHA in a patient with end-stage livre disease
Outcome: 90-day mortality
Predictors of a worse outcome:
(1) transfusion dependence (aOR 9.1) or increased red blood cell transfusion requirements
(2) reduced pre-transfusion hematocrit (aOR 4.7 per 6% decrase)
(3) elevated serum LDH (aOR 2.3 per 100 U/L increase; may be indicative of greater hemolysis)
