Yale study finds that blood draws during sleep hours are frequently conducted for inpatients

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The study shows that more patient-centered hospital care is needed.

A new study found that non-urgent blood draw may often interrupt the sleep of hospitalized patient.

A team of researchers analyzed more than 5,000,000 non-urgent draws of blood collected by Yale New Haven Hospital from 2016 to 2019. They found that a large proportion occurred in a three-hour period early in the morning.

We found that almost four out of ten daily blood draws took place between 4 and 7 am,” said Cesar C. Caraballo, MD, postdoctoral fellow at Yale Center for Outcomes Research and Evaluation. He is also the co-lead researcher of this study. We found that the same pattern was observed across patients of different sociodemographic profiles, including older people who are most at risk for adverse health outcomes from sleep deprivation.

We found that sleep deprivation was associated with adverse health outcomes in patients of different sociodemographic backgrounds, including the elderly who are most at risk.

– Cesar Caraballo-Cordovez, MD

The authors point out that early morning blood tests are sometimes necessary to inform morning medical rounds. However, sleep disruptions can increase the risk of delirium or other adverse health events. “Patients recently hospitalized are at a generalized risk of adverse health events. This condition is called posthospital syndrome”, said Dr. Caraballo-Cordovez. “The stress that patients experience during the hospitalization-including stress from sleep deprivation-is a key contributor to this period of increased risk”.

Harlan M. Krumholz MD, SM professor of medicine and Public Health at Yale and director of CORE, said: “This isn’t an issue that only affects one hospital.” Our findings are a reflection of the way inpatient hospital care in modern medicine is delivered. A more patient-centered approach would limit the number of non-urgent sleep-hour tests. These early morning blood draws, however, are often considered necessary for making decisions during rounds.”

Krumholz added, “We must redesign our process in order to protect the sleep of our patients. However, major changes to our practice should be based on solid studies which demonstrate that strategies can be implemented without causing any adverse effects.”

The study team also included Shiwani Mahjan, Karthik Muugiah Bobak J. Mortazavi Yuan Lu and Rohan Kher, all of whom are from Yale School of Medicine.

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