在接受心脏手术的患者中,红细胞输血后死亡率,术后发病率和费用增加
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
概括
心脏手术后输血红细胞显著增加了感染和缺血并发症. 输血患者面临更长的住院时间,更高的成本和增加的死亡风险.
科学领域:
- 心血管外科心血管外科
- 输血医学 输血医学
- 卫生经济学 卫生经济学
背景情况:
- 红细胞输血是心脏手术中常见的干预措施,具有潜在的益处和危害.
- 信息化输血决策需要了解相关的临床结果和成本.
研究的目的:
- 量化红细胞输血与临床结果之间的关联.
- 评估输血对心脏手术患者医院费用的影响.
主要方法:
- 链接临床,血液学和输血数据库与英国人口登记册.
- 使用重症监护室图表来获得额外的血红素数据.
- 使用回归建模来调整混因素.
主要成果:
- 输血与复合感染 (OR 3.38) 和缺血性结局 (OR 3.35) 的几率增加密切相关.
- 与住院费用增加42%有关,因输血量而有所不同.
- 输血患者的出院可能性降低 (HR 0.63),死亡率更高 (早期和晚期).
结论:
- 在心脏手术患者的红细胞输血与感染和缺血性发病率的显著增加有关.
- 输血与长时间住院,更高的成本以及提升的早期和晚期死亡率有关.
- 这些发现强调了心脏手术中谨慎的输血实践的重要性.
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