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2011年至2020年日本创伤大规模输血实践的趋势:全国性住院患者数据库研究研究
Hiroyuki Ohbe1,2, Takashi Tagami3,4, Akira Endo5
1Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. hohbey@gmail.com.
Journal of intensive care
|October 18, 2023
概括
日本的创伤大规模输血从2011年到2020年有所减少. 较高的新鲜冷血 (FFP) 与红细胞 (RBC) 的比率与更好的结果有关,而血小板比率没有显著变化.
科学领域:
- 创伤重症监护中心的重症监护中心.
- 输血药物 输血药物 输血药物
- 公共卫生监督是对公共卫生的监督.
背景情况:
- 关于创伤大规模输血中最佳的新鲜冷血 (FFP) 与红细胞 (RBC) 和血小板与红细胞的比率,存在相互矛盾的证据.
- 有限的真实世界数据在全国范围内大规模输血创伤的实践.
研究的目的:
- 分析日本创伤大规模输血的全国实践模式和趋势.
- 调查输血比率与患者结果之间的关联.
主要方法:
- 利用国家行政住院患者数据库 (2011-2020年),覆盖约90%的日本三级急诊医院.
- 确定的创伤患者接受大规模输血 (在48小时内≥20个红细胞单位).
- 检查了发病率的趋势,FFP-RBC比率和血小板-RBC比率,以及它们与死亡率和不良事件的关联.
主要成果:
- 在创伤中大规模输血的发生率从0.24% (2011) 降至0.10% (2020).
- FFP与RBC的比率从0.77显著增加到1.08;血小板与RBC的比率保持稳定 (0.71到0.78).
- 较低的FFP-RBC (<0.75) 和血小板-RBC (<1.00) 比率与增加的住院死亡率有关.
结论:
- 在日本 (2011-2020年) 观察到大量输血发生率的下降趋势和FFP-RBC比率的上升趋势.
- 较高的FFP-RBC比率与创伤大规模输血患者改善的结果相关.
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