The CRIT Study: Anemia and blood transfusion in the critically ill - Current clinical practice in the United States
The CRIT Study: Anemia and blood transfusion in the critically ill - Current clinical practice in the United States
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DOI：
10.1097/01.ccm.0000104112.34142.79
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发表时间：
2004-01-01
影响因子：
8.8
通讯作者：
Shapiro, MJ
中科院分区：
文献类型：
--
作者：
Corwin, HL;Gettinger, A;Shapiro, MJ
目的：量化危重患者贫血和红细胞（RBC）输血实践的发生率，并研究贫血和RBC输血与临床outcomes.Design的关系：前瞻性，多中心，观察性队列研究重症监护病房（ICU）患者在美国。招募期为2000年8月至2001年4月。患者在ICU入院后48小时内入组。患者随访30天，出院或死亡，以先发生者为准。设置：213家医院的284个ICU（内科、外科或内科-外科）参与了研究。患者：共有4，892名患者参加了研究。测量和主要结果：基线时的平均血红蛋白水平为11.0 +/- 2.4 g/dL。在整个研究期间，血红蛋白水平降低。总体而言，44%的患者在ICU接受了一个或多个RBC单位（平均值为4.6 +/- 4.9单位）。平均输血前血红蛋白为8.6 +/- 1.7 g/dL。至首次ICU输血的平均时间为2.3 ± 3.7天。在研究第1周给予更多的RBC输注;然而，在随后的几周，受试者在ICU时每周接受1至2个RBC单位。研究期间患者接受的RBC输注次数与ICU和住院时间延长以及死亡率增加独立相关。接受输血的患者也有更多的总并发症，更有可能出现并发症。基线血红蛋白与红细胞输注次数相关，但不是住院时间或死亡率的独立预测因子。然而，血红蛋白水平的最低点
Objective: To quantity the incidence of anemia and red blood cell (RBC) transfusion practice in critically ill patients and to examine the relationship of anemia and RBC transfusion to clinical outcomes.Design: Prospective, multiple center, observational cohort study of intensive care unit (ICU) patients in the United States. Enrollment period was from August 2000 to April 2001. Patients were enrolled within 48 hrs of ICU admission. Patient follow-up was for 30 days, hospital discharge, or death, whichever occurred first.Setting: A total of 284 ICUs (medical, surgical, or medical-surgical) in 213 hospitals participated in the study.Patients: A total of 4,892 patients were enrolled in the study.Measurements and Main Results: The mean hemoglobin level at baseline was 11.0 +/- 2.4 g/dL. Hemoglobin level decreased throughout the duration of the study. Overall, 44% of patients received one or more RBC units while in the ICU (mean, 4.6 +/- 4.9 units). The mean pretransfusion hemoglobin was 8.6 +/- 1.7 g/dL. The mean time to first ICU transfusion was 2.3 +/- 3.7 days. More RBC transfusions were given in study week 1; however, in subsequent weeks, subjects received one to two RBC units per week while in the ICU. The number of RBC transfusions a patient received during the study was independently associated with longer ICU and hospital lengths of stay and an increase in mortality. Patients who received transfusions also had more total complications and were more likely to experience a complication. Baseline hemoglobin was related to the number of RBC transfusions, but it was not an independent predictor of length of stay or mortality. However, a nadir hemoglobin level of