Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802012000200002 |
Resumo: | CONTEXT AND OBJECTIVE: Anemia and blood transfusions are common in intensive care. This study aimed to evaluate epidemiology and outcomes among critically ill patients under a restrictive transfusion strategy. DESIGN AND SETTING: Prospective observational cohort study in an intensive care unit (ICU) at a tertiary hospital. METHODS: All adults admitted to the ICU over a one-year period who remained there for more than 72 hours were included, except those with acute coronary syndrome, ischemic stroke, acute hemorrhage, prior transfusion, pregnant women and Jehovah's Witnesses. The restrictive strategy consisted of transfusion indicated when hemoglobin levels were less than or equal to 7.0 g/dl. RESULTS: The study enrolled 167 patients; the acute physiology and chronic health evaluation II (APACHE II) score was 28.9 ± 6.5. The baseline hemoglobin level was 10.6 ± 2.2 g/dl and on day 28, it was 8.2 ± 1.3 g/dl (P < 0.001). Transfusions were administered to 35% of the patients. In the transfusion group, 61.1% did not survive, versus 48.6% in the non-transfusion group (P = 0.03). Transfusion was an independent risk factor for mortality (P = 0.011; odds ratio, OR = 2.67; 95% confidence interval, CI = 1.25 to 5.69). ICU stay and hospital stay were longer in the transfusion group: 20.0 (3.0-83.0) versus 8.0 (3.0-63.0) days (P < 0,001); and 24.0 (3.0-140.0) versus 14.0 (3.0-80.0) days (P = 0.002), respectively. CONCLUSIONS: In critically ill patients, there was a reduction in hemoglobin with increasing length of ICU stay. Moreover, transfusion was associated with worse prognoses. |
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São Paulo medical journal (Online) |
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Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategyAnemiaBlood transfusionIntensive careHospital mortalityMorbidityCONTEXT AND OBJECTIVE: Anemia and blood transfusions are common in intensive care. This study aimed to evaluate epidemiology and outcomes among critically ill patients under a restrictive transfusion strategy. DESIGN AND SETTING: Prospective observational cohort study in an intensive care unit (ICU) at a tertiary hospital. METHODS: All adults admitted to the ICU over a one-year period who remained there for more than 72 hours were included, except those with acute coronary syndrome, ischemic stroke, acute hemorrhage, prior transfusion, pregnant women and Jehovah's Witnesses. The restrictive strategy consisted of transfusion indicated when hemoglobin levels were less than or equal to 7.0 g/dl. RESULTS: The study enrolled 167 patients; the acute physiology and chronic health evaluation II (APACHE II) score was 28.9 ± 6.5. The baseline hemoglobin level was 10.6 ± 2.2 g/dl and on day 28, it was 8.2 ± 1.3 g/dl (P < 0.001). Transfusions were administered to 35% of the patients. In the transfusion group, 61.1% did not survive, versus 48.6% in the non-transfusion group (P = 0.03). Transfusion was an independent risk factor for mortality (P = 0.011; odds ratio, OR = 2.67; 95% confidence interval, CI = 1.25 to 5.69). ICU stay and hospital stay were longer in the transfusion group: 20.0 (3.0-83.0) versus 8.0 (3.0-63.0) days (P < 0,001); and 24.0 (3.0-140.0) versus 14.0 (3.0-80.0) days (P = 0.002), respectively. CONCLUSIONS: In critically ill patients, there was a reduction in hemoglobin with increasing length of ICU stay. Moreover, transfusion was associated with worse prognoses.Associação Paulista de Medicina - APM2012-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802012000200002Sao Paulo Medical Journal v.130 n.2 2012reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/S1516-31802012000200002info:eu-repo/semantics/openAccessSilva Junior,João Manoel daRezende,EderlonAmendola,Cristina PradaTomita,RafaelTorres,DanieleFerrari,Maria TerezaToledo,Diogo OliveiraOliveira,Amanda Maria Ribas RosaMarques,Juliana Andreiaeng2012-04-03T00:00:00Zoai:scielo:S1516-31802012000200002Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2012-04-03T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy |
title |
Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy |
spellingShingle |
Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy Silva Junior,João Manoel da Anemia Blood transfusion Intensive care Hospital mortality Morbidity |
title_short |
Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy |
title_full |
Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy |
title_fullStr |
Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy |
title_full_unstemmed |
Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy |
title_sort |
Red blood cell transfusions worsen the outcomes even in critically ill patients undergoing a restrictive transfusion strategy |
author |
Silva Junior,João Manoel da |
author_facet |
Silva Junior,João Manoel da Rezende,Ederlon Amendola,Cristina Prada Tomita,Rafael Torres,Daniele Ferrari,Maria Tereza Toledo,Diogo Oliveira Oliveira,Amanda Maria Ribas Rosa Marques,Juliana Andreia |
author_role |
author |
author2 |
Rezende,Ederlon Amendola,Cristina Prada Tomita,Rafael Torres,Daniele Ferrari,Maria Tereza Toledo,Diogo Oliveira Oliveira,Amanda Maria Ribas Rosa Marques,Juliana Andreia |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Silva Junior,João Manoel da Rezende,Ederlon Amendola,Cristina Prada Tomita,Rafael Torres,Daniele Ferrari,Maria Tereza Toledo,Diogo Oliveira Oliveira,Amanda Maria Ribas Rosa Marques,Juliana Andreia |
dc.subject.por.fl_str_mv |
Anemia Blood transfusion Intensive care Hospital mortality Morbidity |
topic |
Anemia Blood transfusion Intensive care Hospital mortality Morbidity |
description |
CONTEXT AND OBJECTIVE: Anemia and blood transfusions are common in intensive care. This study aimed to evaluate epidemiology and outcomes among critically ill patients under a restrictive transfusion strategy. DESIGN AND SETTING: Prospective observational cohort study in an intensive care unit (ICU) at a tertiary hospital. METHODS: All adults admitted to the ICU over a one-year period who remained there for more than 72 hours were included, except those with acute coronary syndrome, ischemic stroke, acute hemorrhage, prior transfusion, pregnant women and Jehovah's Witnesses. The restrictive strategy consisted of transfusion indicated when hemoglobin levels were less than or equal to 7.0 g/dl. RESULTS: The study enrolled 167 patients; the acute physiology and chronic health evaluation II (APACHE II) score was 28.9 ± 6.5. The baseline hemoglobin level was 10.6 ± 2.2 g/dl and on day 28, it was 8.2 ± 1.3 g/dl (P < 0.001). Transfusions were administered to 35% of the patients. In the transfusion group, 61.1% did not survive, versus 48.6% in the non-transfusion group (P = 0.03). Transfusion was an independent risk factor for mortality (P = 0.011; odds ratio, OR = 2.67; 95% confidence interval, CI = 1.25 to 5.69). ICU stay and hospital stay were longer in the transfusion group: 20.0 (3.0-83.0) versus 8.0 (3.0-63.0) days (P < 0,001); and 24.0 (3.0-140.0) versus 14.0 (3.0-80.0) days (P = 0.002), respectively. CONCLUSIONS: In critically ill patients, there was a reduction in hemoglobin with increasing length of ICU stay. Moreover, transfusion was associated with worse prognoses. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802012000200002 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802012000200002 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1516-31802012000200002 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.130 n.2 2012 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209263358574592 |