The effect of red-blood-cell transfusion on fatigue in hospitalized patients with anaemia.
The effect of red-blood-cell transfusion on fatigue in hospitalized patients with anaemia.
复制标题
DOI：
10.1111/vox.12704
复制
发表时间：
2018-10
期刊：
影响因子：
2.7
通讯作者：
Meltzer DO
中科院分区：
文献类型：
--
作者：
Prochaska MT;Newcomb R;Jiang D;Meltzer DO
指南建议，大多数住院患者的红细胞输注决定应基于血红蛋白（Hb）浓度和贫血症状（包括疲劳）的存在。然而，研究在输血是否与疲劳的改善有关方面存在分歧。一种解释是，输血的益处因基线疲劳水平而异，现有的研究尚未研究。本研究的目的是确定住院期间输血与出院后30天疲劳改善之间的相关性是否因基线疲劳水平而异。一项前瞻性观察性研究，对任何Hb <9 g/dL的住院普通内科患者进行了研究。镰状细胞性贫血和胃肠道出血患者被排除，因为这些诊断具有替代输血实践。抑郁症患者被排除在外，因为他们的疲劳主要不是由于贫血。在面对面访谈和出院后30天电话访谈期间测量疲劳。从医院管理数据中收集Hb值和输血情况。使用线性回归来测试“疲劳变化”、血红蛋白浓度和接受输血之间的关联。对于基线疲劳程度较高的患者，输血与最低Hb相互作用与出院后疲劳程度减轻相关（20%最疲劳：β=12，p=0.02; 10%最疲劳：β=17，p=0.02）。具有高基线疲劳的<50岁的患者因输血而产生的疲劳大幅减少（20%：β=23，p=0.02; 10%：β=29，p=0.03）。对于基线疲劳水平较高的患者，住院期间输血与出院后30天疲劳减轻相关。
Guidelines suggest that red blood cell transfusion decisions for most hospitalized patients be based on hemoglobin (Hb) concentration and the presence of symptoms of anemia, including fatigue. However, studies differ in whether transfusion is associated with improvements in fatigue. One explanation is that the benefit of transfusion varies by baseline fatigue levels, which existing studies have not examined. The objective of this study was to determine whether the association between transfusion during hospitalization and improvements in fatigue 30 days post-discharge varies by baseline fatigue level. A prospective observational study of hospitalized general medicine patients with any Hb <9g/dL. Patients with sickle cell anemia and gastrointestinal bleeding were excluded since these diagnoses have alternative transfusion practices. Patients with depression were excluded because their fatigue is not primarily due to anemia. Fatigue was measured during an in-person interview and a 30 day post-discharge phone interview. Hb values and receipt of a transfusion were collected from hospital administrative data. Linear regression was used to test associations between “change in fatigue”, Hb concentration, and receipt of a transfusion. Transfusion interacted with nadir Hb was associated with reduced fatigue post-discharge for patients with higher baseline fatigue (20% most fatigued: β=12, p=0.02; 10% most fatigued: β=17, p=0.02). Patients <50 years old with high baseline fatigue had large reductions in fatigue from transfusion (20%: β=23, p=0.02; 10%: β=29, p=0.03). Transfusion during hospitalization is associated with reduced fatigue 30 days post-discharge in patients with higher levels of baseline fatigue.
登录
查看更多内容
影响因子：
4.7
作者：
Ho SY;Rohan KJ;Parent J;Tager FA;McKinley PS
通讯作者：
McKinley PS
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
39.2
作者：
Carson, Jeffrey L.;Grossman, Brenda J.;Djulbegovic, Benjamin
通讯作者：
Djulbegovic, Benjamin
影响因子：
3.6
作者：
Telen, MJ
通讯作者：
Telen, MJ
影响因子：
3.6
作者：
Webster K;Cella D;Yost K
通讯作者：
Yost K