The association between duration of storage of transfused red blood cells and morbidity and mortality after reoperative cardiac surgery (Retracted Article)
The association between duration of storage of transfused red blood cells and morbidity and mortality after reoperative cardiac surgery (Retracted Article)
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DOI：
10.1213/01.ane.0000221167.58135.3d
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发表时间：
2006-07-01
影响因子：
5.7
通讯作者：
Bennett-Guerrero, Elliott
中科院分区：
文献类型：
--
作者：
Basran, Sukhjeewan;Frumento, Robert J.;Bennett-Guerrero, Elliott
红细胞 (RBC) 在储存过程中会发生许多变化；然而，这些储存“病变”的临床相关性尚不清楚。我们假设，输注红细胞的储存时间与心脏手术重复胸骨切开术后的死亡率相关，因为这些患者红细胞输注和不良后果的风险都很高。我们回顾性分析了 434 名因冠状动脉搭桥术或瓣膜手术而接受重复正中胸骨切开术并接受同种异体红细胞的患者。三百二十一名 (74%) 患者符合资格标准。调整混杂因素和红细胞输注总数的影响后，发现输注的最旧红细胞单位的储存时间与院内死亡率（Cox 比例风险比 (HR) = 1.151；P < 0.0001）和院外死亡率（HR = 1.116；P < 0.0001）相关。输注红细胞的平均储存时间也是院内死亡率的独立预测因素（HR = 1.036；P < 0.0001）。还观察到输注红细胞的储存时间与急性肾功能不全以及重症监护病房和住院时间之间的独立关联。红细胞的储存时间与心脏手术重复胸骨切开术后的不良后果相关。这一发现的临床意义应该通过大型、随机、盲法临床试验来研究。
Red blood cells (RBCs) undergo numerous changes during storage; however, the clinical relevance of these storage "lesions" is unclear. We hypothesized that the duration of storage of transfused RBCs is associated with mortality after repeat sternotomy for cardiac surgery, because these patients are at high risk for both RBC transfusion and adverse outcome. We retrospectively analyzed 434 patients who underwent repeat median sternotomy for coronary artery bypass graft or valve surgery and who received allogeneic RBCs. Three-hundred-twenty-one (74%) patients met the criteria for eligibility. After adjusting for the effects of confounders and the total number of RBC transfusions, the duration of storage of the oldest RBC unit, transfused was found to be associated with both in-hospital mortality (Cox proportional hazard ratio (HR) = 1.151; P < 0.0001) and out-of-hospital mortality (HR = 1.116; P < 0.0001). The mean duration of storage of transfused RBCs was also an independent predictor of in-hospital mortality (HR = 1.036; P < 0.0001). Independent associations between the duration of storage of transfused RBCs and acute renal dysfunction and intensive care unit and hospital length of stay were also observed. The duration of storage of RBCs is associated with adverse outcome after repeat sternotomy for cardiac surgery. The clinical significance of this finding should be investigated in a large, randomized, blinded clinical trial.