严重创伤的输血实践在医院间的变化
Troy N Coaston1, Amulya Vadlakonda1, Saad Mallick1
1Center for Advanced Surgical & Interventional Technology (CASIT), David Geffen School of Medicine at University of California, Los Angeles CA 90024, USA.
Injury
|July 31, 2025
概括
输血中血与红细胞 (RBC) 的高比率与创伤患者的更好的生存率有关. 比例较高的中心显示死亡率降低,表明其作为质量指标的价值.
科学领域:
- 创伤和紧急医疗医学
- 输血医学 输血医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 不断发展的输血实践强调血:红细胞 (RBC) 比率,≥1:1比率与改善的生存率有关.
- 血的医院间变化:RBC比率及其对住院患者死亡率的影响需要评估.
研究的目的:
- 为了评估血的医院间变异性:严重受伤的成年患者中的RBC比率.
- 为了确定高血:RBC比率和住院患者死亡率之间的关联.
主要方法:
- 从2020-2021年创伤质量改善计划数据库中分析了35,215名成年创伤患者.
- 利用多层混合效应模型来估计风险调整的血:每个中心的RBC比率,识别高比率中心 (HRC).
- 采用多变量逻辑回归来确定死亡率预测因素.
主要成果:
- 38.0%的患者在HRC接受治疗,估计占血:RBC变化的17%.
- 在HRCs (调整几率比 (AOR) 0.81) 和均衡输血 (AOR 0.92) 的护理与降低死亡率有关.
- 即使在不平衡的输血中 (AOR 0.84),HRCs的好处也持续存在.
结论:
- 高血:创伤中心的红细胞比率与住院患者死亡率的降低有关.
- 这一比率作为一个有价值的医院质量指标,用于输血实践.
- 这些发现支持采用更高的血:RBC比率在创伤护理中.
相关概念视频
Blood Transfusion and Agglutination
11.2K
Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
11.2K
Blood Transfusion
814
Blood transfusion is a critical medical procedure that saves lives and treats various medical conditions. It involves transferring blood from a donor to a recipient. This process requires a thorough understanding of the ABO blood group system and its associated antigens and antibodies.
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
814
Venous Thrombosis IV: Nursing Management
24
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
24
Heart Failure VI: Adjunct Therapies
28
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
28


