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全血输血与受伤儿科患者死亡率之间的关联
Makoto Aoki1, Morihiro Katsura2,3, Kazuhide Matsushima3
1Advanced Medical Emergency Department and Critical Care Center, Japan Red Cross Maebashi Hospital, Maebashi, Japan.
Annals of surgery
|November 8, 2023
概括
在需要立即输血的受伤儿童中,全血 (WB) 输血与更好的生存率有关. 这项研究发现,WB在输血后24小时和30天内显著降低了死亡风险.
科学领域:
- 儿科创伤护理 儿童创伤护理
- 输血医学 输血医学
- 紧急医疗 紧急医疗
背景情况:
- 对于创伤患者来说,越来越多地考虑全血 (WB) 输血.
- 虽然研究表明成人生存率有所改善,但儿童创伤的证据有限.
- 这项研究解决了了解WB对儿科创伤生存的影响的差距.
研究的目的:
- 评估全血 (WB) 输血与受伤儿童死亡率之间的关联.
- 为了确定WB输血是否改善了儿童创伤患者的生存结果,需要立即输血.
主要方法:
- 使用ACS-TQIP数据库 (2020-2021) 进行回顾性队列研究.
- 包括儿童患者 (≤16岁),在到达后4小时内接受即时输血.
- 倾向性得分匹配 (1:1) 用于比较WB和组件疗法组之间的24小时和30天生存率.
主要成果:
- 在2729名符合条件的儿科患者中,319人 (11.7%) 接受了WB.
- 在倾向分数匹配后,WB输血与24小时死亡风险降低42%有关 (HR0.58,P=0.042).
- 在30天后也观察到显著的生存益处 (HR0.65,P=0.011).
结论:
- 全血输血与儿童创伤患者的生存率改善有关,这些患者需要立即输血.
- 研究结果支持考虑WB在严重受伤的儿童中立即输血.
- 进一步的研究可能会阐明儿童创伤中WB使用的最佳协议.
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