老红细胞输血对危急疾病患者结果的影响:一项回顾性队列研究
Nchafatso G Obonyo1,2,3,4,5, Declan P Sela1,2, Nicole White1,6
1Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.
Vox sanguinis
|March 3, 2025
概括
在危急病患者中,输入接近到期 (≥35天) 的较旧的包装红细胞 (pRBC) 与更糟糕的结果有关. 这项研究发现,使用这些较老的PRBC时,死亡率和住院时间增加.
科学领域:
- 关键护理医学 关键护理医学
- 输血医学 输血医学
- 血液学 血液学 血液学
背景情况:
- 随机对照试验表明,新鲜包装的红细胞 (pRBC) 不会影响重症患者的结果.
- 有限的证据存在于临床影响的输血pRBC接近其到期日 (35-42天).
研究的目的:
- 为了研究输血接近其保质期 (≥35天) 结束的pRBC和重症患者的临床结果之间的关联.
- 确定较老的PRBC是否影响住院死亡率,住院时间和出院目的地.
主要方法:
- 澳大利亚昆士兰州 (2007-2013) 电子医疗记录的回顾性观察分析.
- 包括10,350名患病危急的成年患者,他们至少接受了一单位未经辐射的PRBC.
- 多变量逻辑和线性回归用于分析较旧的PRBC输血和结果之间的关联.
主要成果:
- 输血至少一个单位的pRBC年龄≥35天与增加的住院死亡率有关 (OR 1.21).
- 较老的PRBC与往常住所出院的减少 (OR0.81) 和住院时间的增加 (估计为2.55天) 相相关.
- 还发现了与增加的败血症 (OR 1.27) 和妄 (OR 1.25) 的关联.
结论:
- 35天或以上的包装红细胞 (pRBC) 的输血与重症患者的发病率和死亡率较高有关.
- 在重症监护机构使用较旧的PRBC会对临床结果产生负面影响.
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