Nareg Roubinian, MD

Pulmonary Medicine, KP Oakland

“Until recently, outcome data guiding the management of anemic patients after hospitalization has been limited. But thanks to our integrated health care system, we’ve been able to follow anemic patients for months or years after they go home.”

Dr. Roubinian is one of those physicians who thrives on wearing more than one hat. After finishing a fellowship in critical care medicine in 2011, he knew he wanted to be a clinician. Shortly afterward, an opportunity to do clinical research helped him discover he was just as passionate about clinical investigations as he was caring for patients. So when he joined TPMG in 2015 to practice as a pulmonologist while conducting research, he knew he’d discovered the best of both worlds.

Over the last decade, Dr. Roubinian has pursued research in the field of blood transfusion, noticing that much about its epidemiology, particularly as it relates to anemia, is unknown. Recognizing a lack of data on how patients with anemia should be managed following their intensive care and hospital stays, he embarked on a research collaboration to evaluate patient outcomes longitudinally, following hospital care.

Anemia is common in hospitalized patients and has been independently associated with morbidity and mortality. In the past, physicians often treated anemia with transfusions to increase hemoglobin levels, but a series of randomized controlled trials showed similar outcomes with less frequent red blood cell transfusion.

Dr. Roubinian and his Division of Research colleagues followed a cohort of nearly half a million patients over 5 years. They found that a decline in the use of red blood cell transfusions was associated with an increase in anemia during and following hospitalization, but that this increase was not associated with adverse effects on long-term outcomes. In fact, what they found were improved outcomes in anemic patients in parallel with those of all other hospitalized patients in KP Northern California.

“Dr. Roubinian humbly and expertly strikes a perfect balance between clinical practice and research,” says Rita Ng, MD, co-physician-in-chief for KP East Bay. “This study adds to the evidence regarding the safety of transfusion guidelines and hopefully will provide some reassurance to physicians when deciding whether to discharge a patient with anemia home.”