Please use this identifier to cite or link to this item: https://doi.org/10.1186/s13054-014-0487-z
Title: The effect of age and clinical circumstances on the outcome of red blood cell transfusion in critically ill patients
Authors: Dejam, A
Malley, B.E
Feng, M 
Cismondi, F
Park, S
Samani, S
Samani, Z.A
Pinto, D.S
Celi, L.A
Keywords: hemoglobin
adult
age
aged
Article
cancer patient
cardiac patient
comorbidity
controlled study
coronary care unit
critically ill patient
erythrocyte transfusion
female
heart surgery
hematocrit
human
intensive care
intensive care unit
major clinical study
male
mortality
oxygen consumption
patient monitoring
propensity score
retrospective study
sensitivity analysis
sepsis
Sequential Organ Failure Assessment Score
surgical patient
survival
treatment outcome
age
anemia
erythrocyte transfusion
hospital mortality
intensive care
mortality
regression analysis
risk factor
Age Factors
Aged
Anemia
Critical Care
Erythrocyte Transfusion
Female
Hospital Mortality
Humans
Male
Propensity Score
Regression Analysis
Retrospective Studies
Risk Factors
Treatment Outcome
Issue Date: 2014
Publisher: BioMed Central Ltd.
Citation: Dejam, A, Malley, B.E, Feng, M, Cismondi, F, Park, S, Samani, S, Samani, Z.A, Pinto, D.S, Celi, L.A (2014). The effect of age and clinical circumstances on the outcome of red blood cell transfusion in critically ill patients. Critical Care 18 (4) : 487. ScholarBank@NUS Repository. https://doi.org/10.1186/s13054-014-0487-z
Rights: Attribution 4.0 International
Abstract: Introduction: Whether red blood cell (RBC) transfusion is beneficial remains controversial. In both retrospective and prospective evaluations, transfusion has been associated with adverse, neutral, or protective effects. These varying results likely stem from a complex interplay between transfusion, patient characteristics, and clinical context. The objective was to test whether age, comorbidities, and clinical context modulate the effect of transfusion on survival.Methods: By using the multiparameter intelligent monitoring in intensive care II database (v. 2.6), a retrospective analysis of 9,809 critically ill patients, we evaluated the effect of RBC transfusion on 30-day and 1-year mortality. Propensity score modeling and logistic regression adjusted for known confounding and assessed the independent effect of transfusion on 30-day and 1-year mortality. Sensitivity analysis was performed by using 3,164 transfused and non-transfused pairs, matched according the previously validated propensity model for RBC transfusion.Results: RBC transfusion did not affect 30-day or 1-year mortality in the overall cohort. Patients younger than 55 years had increased odds of mortality (OR, 1.71; P < 0.01) with transfusion. Patients older than 75 years had lower odds of 30-day and 1-year mortality (OR, 0.70; P < 0.01) with transfusion. Transfusion was associated with worse outcome among patients undergoing cardiac surgery (OR, 2.1; P < 0.01). The propensity-matched population corroborated findings identified by regression adjustment.Conclusion: A complex relation exists between RBC transfusion and clinical outcome. Our results show that transfusion is associated with improved outcomes in some cohorts and worse outcome in others, depending on comorbidities and patient characteristics. As such, future investigations and clinical decisions evaluating the value of transfusion should account for variations in baseline characteristics and clinical context. © 2014 Dejam et al.; licensee BioMed Central Ltd.
Source Title: Critical Care
URI: https://scholarbank.nus.edu.sg/handle/10635/180138
ISSN: 1364-8535
DOI: 10.1186/s13054-014-0487-z
Rights: Attribution 4.0 International
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