Routine Labs in Hospital Patients: Iatrogenic Anemia and Missed Acute Kidney Injury

Guidelines recommend avoiding unnecessary laboratory tests to minimize risks of anemia in hospitalized patients as well as reduce costs. Avoiding routine labs, however, may introduce new risks of missing conditions that do not have physical exam or history findings, such as Acute Kidney Injury. This study analyzes retrospective data for routine laboratory results and simulates different strategies for skipping labs. It estimates potential benefits from avoiding iatrogenic anemia as well as costs from increased risk of Acute Kidney Injury. In a simplified estimate of pure dollar costs, the costs of daily labs appear to significantly outweigh the costs of missing Acute Kidney Injury, but there are costs to skipping routine labs.