Red Blood Cell Transfusions Are Not Associated With Incident Complications or Poor Outcomes in Patients With Intracerebral Hemorrhage.
Red Blood Cell Transfusions Are Not Associated With Incident Complications or Poor Outcomes in Patients With Intracerebral Hemorrhage.
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DOI：
10.1161/jaha.122.028816
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发表时间：
2023-06-06
影响因子：
5.4
通讯作者：
Roh, David J.
中科院分区：
文献类型：
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作者：
Poyraz, Fernanda Carvalho;Boehme, Amelia;Cottarelli, Azzurra;Eisler, Lisa;Elkind, Mitchell S. V.;Ghoshal, Shivani;Agarwal, Sachin;Park, Soojin;Claassen, Jan;Connolly, E. Sander;Hod, Eldad A.;Roh, David J.
贫血与脑出血(ICH)预后不良有关，但输注红细胞(RBC)与脑出血并发症和功能预后的关系尚不清楚。我们调查了输注红细胞对脑出血患者院内血栓、感染并发症和预后的影响。对2009-2018年间连续参加单中心前瞻性队列研究的自发性脑出血患者进行了评估。初步分析评估了红细胞输注与输血后发生的血栓栓塞症和感染并发症的关系。二次分析评估了红细胞输注与死亡率和出院情况差的关系。改良的Rankin量表评分为4到6分。多变量Logistic回归模型调整了基线人口统计学和内科疾病严重程度(急性生理学和慢性健康评估II)和脑出血严重程度(ICH评分)。在所分析的587名脑出血患者中，88(15%)至少接受了一次红细胞输注。接受红细胞输注的患者的内科和脑出血严重程度更差。虽然接受红细胞输注的患者在住院期间的任何时候都有更多的并发症(64.8%比35.9%)，但在我们的回归模型中，我们发现红细胞输注与事件并发症之间没有关联(调整后的优势比[AOR]，0.71[95%CI，0.42-1.20])。在调整了疾病严重程度和其他相关变量后，我们发现RBC输注与死亡率(AOR，0.87[95%CI，0.45-1.66])和出院差的改良Rankin量表评分(AOR，2.45[95%CI，0.80-7.61])之间没有显著相关性。在我们的脑出血队列中，红细胞输注预计会被给予内科和脑出血严重程度更高的患者。考虑到疾病的严重程度和输血的时机，输注红细胞与医院并发症或不良的临床脑出血预后无关。
Anemia is associated with poor intracerebral hemorrhage (ICH) outcomes, yet the relationship of red blood cell (RBC) transfusions to ICH complications and functional outcomes remains unclear. We investigated the impact of RBC transfusion on hospital thromboembolic and infectious complications and outcomes in patients with ICH. Consecutive patients with spontaneous ICH enrolled in a single‐center, prospective cohort study from 2009 to 2018 were assessed. Primary analyses assessed relationships of RBC transfusions on incident thromboembolic and infectious complications occurring after the transfusion. Secondary analyses assessed relationships of RBC transfusions with mortality and poor discharge modified Rankin Scale score 4 to 6. Multivariable logistic regression models adjusted for baseline demographics and medical disease severity (Acute Physiology and Chronic Health Evaluation II), and ICH severity (ICH score).Of 587 patients with ICH analyzed, 88 (15%) received at least one RBC transfusion. Patients receiving RBC transfusions had worse medical and ICH severity. Though patients receiving RBC transfusions had more complications at any point during the hospitalization (64.8% versus 35.9%), we found no association between RBC transfusion and incident complications in our regression models (adjusted odds ratio [aOR], 0.71 [95% CI, 0.42–1.20]). After adjusting for disease severity and other relevant covariates, we found no significant association between RBC transfusion and mortality (aOR, 0.87 [95% CI, 0.45–1.66]) or poor discharge modified Rankin Scale score (aOR, 2.45 [95% CI, 0.80–7.61]). In our cohort with ICH, RBC transfusions were expectedly given to patients with higher medical and ICH severity. Taking disease severity and timing of transfusions into account, RBC transfusion was not associated with incident hospital complications or poor clinical ICH outcomes.
影响因子：
2.9
作者：
Prestia K;Bandyopadhyay S;Slate A;Francis RO;Francis KP;Spitalnik SL;Fidock DA;Brittenham GM;Hod EA
通讯作者：
Hod EA