心臓外科手術を受けた患者の赤血球輸血後の死亡率,手術後の罹病率,および費用の増加
Gavin J Murphy1, Barnaby C Reeves, Chris A Rogers
1Bristol Heart Institute, University of Bristol, Bristol Royal Infirmary, Bristol, BS2 8HW, UK.
Circulation
|November 14, 2007
まとめ
心臓外科手術後の赤血球輸血は,感染症と不血性合併症を大幅に増加させます. 輸血を受けた患者は,より長い入院期間,より高い費用,および死亡リスクの増加に直面します.
科学分野:
- 心血管外科手術についてです.
- 輸血医学とは
- 健康経済学 医療経済学
背景:
- 赤血球輸血は,潜在的利益と害を持つ心臓手術における一般的な介入です.
- 輸血に関する決定を下すための情報提供には,関連する臨床的結果と費用の理解が必要です.
研究 の 目的:
- 赤血球輸血と臨床結果の間の関連性を定量化するために.
- 心臓外科手術患者の病院費用に対する輸血の影響を評価する.
主な方法:
- 臨床,血液学,輸血のデータベースを英国の人口登録簿とリンクした.
- ヘマトクリットデータを追加するために,集中治療室の図を用いた.
- 混同要因を調整するために回帰モデリングを使用しました.
主要な成果:
- 輸血は,複合性感染症 (OR 3.38) と缺血性アウトカム (OR 3.35) の確率の増加と強く関連しています.
- 輸血量によって異なる入院費用の42%の増加と関連しています.
- 輸血を受けた患者は退院の可能性が低下 (HR 0.63) し,死亡率 (早期および遅刻) が高かった.
結論:
- 心臓外科手術患者の赤血球輸血は,感染症と不全性疾患の有意な増加と関連しています.
- 輸血は,長期の入院,より高い費用,および早期および遅い死亡率の増加と関連しています.
- 発見は,心臓外科手術における賢明な輸血慣行の重要性を強調しています.
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