在接受治疗性血交换的住院患者中,出血复发风险:一项多中心研究
Alexandre Soares Ferreira Junior1, Morgana Pinheiro Maux Lessa1, Kate Sanborn2
1Department of Medicine, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil.
Blood transfusion = Trasfusione del sangue
|August 12, 2024
概括
出血复发影响39%的住院患者接受治疗性血交换 (TPE) 在之前出血事件后. 关键预测因素包括重症监护病房停留,血小板减少,肝病和TPE手术的数量.
科学领域:
- 血液学 血液学 血液学
- 临床医学 临床医学
- 患者安全 患者安全
背景情况:
- 接受治疗性血交换 (TPE) 的住院患者面临出血风险.
- 之前出血事件对TPE相关出血风险的影响尚不清楚.
研究的目的:
- 评估TPE前有重大出血史的患者出血复发的患病率.
- 确定与TPE期间出血复发相关的预测因素和相互作用.
主要方法:
- 对接受者流行病学和捐赠者评估研究-III (REDS-III) 数据库的回顾性横截面分析.
- 确定了在TPE之前患有严重出血的住院成年人,并根据出血复发情况对其进行分类.
- 使用多次归算和最小绝对收缩的逻辑回归和可变选择的选择运算符.
主要成果:
- 在310名先前有重大出血的患者中,39%的患者在TPE期间出现了复发.
- 确定了七个预测因素:>10个TPE手术,ICU停留,血小板狭窄,手术,肝病,6-10个TPE手术和亚洲种族.
- 发现了五种显著的相互作用,包括手术/抗凝和TPE程序/抗血小板.
结论:
- 确定了7个关键预测因子和5个相互作用,用于TPE患者之前有出血史的出血复发.
- 这些发现突出了影响出血风险的特定患者因素和治疗特征.
- 建议进行进一步的验证研究来证实这些预测因素.
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