Clinical impact of red blood cell transfusion on adverse clinical events in acute heart failure patients with anemia
Clinical impact of red blood cell transfusion on adverse clinical events in acute heart failure patients with anemia
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红细胞输注对贫血急性心力衰竭患者不良临床事件的临床影响
DOI：
10.1016/j.ijcard.2020.09.028
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发表时间：
2021
期刊：
影响因子：
3.5
通讯作者：
Matsuda T
中科院分区：
文献类型：
--
作者：
Higuchi S;Hata N;Shibata S;Hirabuki K;Suda T;Honda K;Hasegawa H;Matsuda T
贫血是急性心力衰竭（AHF）患者的一种重要合并症，与不良临床事件有关。然而，红细胞（RBC）输注在这样的patients.MethodThis研究的临床影响是一个回顾性的单中心注册表，包括AHF患者在2007年和2014年之间入住杏林大学医院。贫血定义为男性血红蛋白水平< 130 g/L或女性< 120 g/L。排除血红蛋白浓度下降>20 g/L的大出血患者。AHF再入院3个月，在医院和2年的全因mortality evaluated.ResultsOf 501 AHF患者，38人被排除，由于大出血，最后，463（年龄，77 ± 11岁，男性，58%）进行了评估。112例患者（24%）在住院期间进行了RBC输注。入院时血红蛋白水平为105 ± 16 g/L（输血，89 ± 17 g/L;未输血，110 ± 12 g/L;p< 0.001）。分别在46例（10%）、16例（3%）和121例（26%）患者中观察到3个月时AHF再入院以及住院和2年全因死亡率。单变量考克斯回归分析表明，红细胞输注与3个月时AHF再入院无关（风险比：0.80; 95%置信区间：0.39-1.66），该关联在任何血红蛋白浓度或左心室射血分数值下均无差异。多因素考克斯回归分析显示相似的结果。此外，红细胞输注与院内和2年全因mortality.ConclusionsRBC输注与AHF再入院或全因死亡率无关。
BackgroundAnemia has been recognized as an important comorbidity in patients with acute heart failure (AHF) and is associated with adverse clinical events. However, the clinical impact of red blood cell (RBC) transfusion in such patients is unclear.MethodThis study was a retrospective single-center registry including AHF patients admitted to Kyorin University Hospital between 2007 and 2014. Anemia was defined as a hemoglobin level < 130 g/L in males or < 120 g/L in females. Those with major bleeding with a fall in hemoglobin concentration of >20 g/L were excluded. AHF readmission at 3 months and in-hospital and 2-year all-cause mortality were evaluated.ResultsOf 501 AHF patients, 38 were excluded owing to major bleeding; finally, 463 (age, 77 ± 11 years; males, 58%) were evaluated. RBC transfusion during hospitalization was performed in 112 patients (24%). Hemoglobin level on admission was 105 ± 16 g/L (transfusion, 89 ± 17 g/L; no transfusion, 110 ± 12 g/L;p< 0.001). AHF readmission at 3 months and in-hospital and 2-year all-cause mortality were observed in 46 (10%), 16 (3%), and 121 (26%) patients, respectively. Univariate Cox regression analysis demonstrated that RBC transfusion was not associated with AHF readmission at 3 months (hazard ratio: 0.80; 95% confidence interval: 0.39–1.66) The association did not differ at any hemoglobin concentration or left ventricular ejection fraction value. Multivariate Cox regression analysis revealed similar results. Furthermore, RBC transfusion was not correlated with in-hospital and 2-year all-cause mortality.ConclusionsRBC transfusion was not associated with AHF readmission or all-cause mortality.