除了红细胞输血外,外科手术期间的血与术后静脉血栓栓塞的风险增加有关
Una E Choi1, Ryan C Nicholson1, Steven M Frank1
1From the Departments of Anesthesiology and Critical Care Medicine.
Anesthesia and analgesia
|February 28, 2024
概括
在手术患者中,将血添加到红细胞 (RBC) 输血中会增加死亡和严重并发症的风险,如静脉血栓塞栓症 (VTE),肺栓塞 (PE) 和分散的血管内凝血 (DIC).
科学领域:
- 输血医学 输血医学
- 外科手术的结果
- 患者血液管理患者血液管理
背景情况:
- 术后红细胞 (RBC) 输血与静脉血栓栓塞 (VTE) 事件的增加有关.
- 在VTE上,除了红细胞外,额外的外科手术期间血的特定风险尚未得到充分确立.
研究的目的:
- 为了研究术后血和红细胞输血与仅红细胞输血与术后结果之间的关联.
- 评估在接受额外血的手术患者中死亡率,静脉动脉,肺栓塞 (PE) 和扩散性血管内凝血 (DIC) 的风险.
主要方法:
- 美国索赔和电子健康记录数据库 (TriNetX钻石网络) 的回顾性分析.
- 将接受外科手术期间血和红血细胞的手术患者与仅接受红血细胞的患者进行比较.
- 倾向性得分匹配用于对所有手术和心血管手术的分析中对患者特征和手术类型进行控制.
主要成果:
- 与仅接受红细胞输血的患者相比,接受血+红细胞输血的患者30天死亡风险更高 (RR: 1.36),VTE (RR: 1.36),PE (RR: 1.46) 和DIC (RR: 2.75).
- 在心血管手术患者的小组中也观察到这些增加的风险.
结论:
- 将血添加到外科手术期间的红细胞输血中,与死亡,VTE,PE和DIC的风险增加有关.
- 减少不必要的血输血对于患者的血液管理和改善医疗保健价值至关重要.
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