Perioperative Blood Transfusion and Postoperative Mortality

Carson, Jeffrey L.; Duff, Amy; Berlin, Jesse A.; Lawrence, Valerie A.; Poses, Roy M.; Huber, Elizabeth C.; O′Hara, Dorene A.; Noveck, Helaine; Strom, Brian L.

doi:10.1016/s0022-5347(01)63153-7

Cited by 24 publications

(30 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our that blood transfusion was associated with a 25% lower risk of death (Table 5, Figure 2 results of no effect of transfusion on short-term (0-30 and 31-180 days) survival in ICU patients are consistent with results of studies in orthopedic patients 10,15,16 and of some studies in cancer patients. 17,18 However, in other studies in surgical cancer patients and in studies of patients undergoing cardiac surgery, the risk of mortality was increased, for at least 1 year, in patients receiving a transfusion.…”

Section: Discussionsupporting

confidence: 86%

Long-term Survival in the Intensive Care Unit After Erythrocyte Blood Transfusion

Engoren

Arslanian‐Engoren

2009

American Journal of Critical Care

View full text Add to dashboard Cite

Background Erythrocyte blood transfusions are commonly used in intensive care units, yet little is known about their effects on long-term survival. Objective To determine the effect of erythrocyte blood transfusion in intensive care units on long-term survival. Methods Retrospective analysis of a prospectively collected database of 2213 patients admitted January 27, 2001, to April 30, 2002, to the cardiac, burn, neurological-neurosurgical, and combined medical-surgical intensive care units in a tertiary care, university-affiliated, urban medical center. Further analysis was done on a case-control subgroup (n = 556) formed by matching scores on the Acute Physiology and Chronic Health Evaluation (APACHE) II and propensity scores. Results Although transfusion was univariably associated with increased risk of death at all 3 times (0-30, 31-180, and >180 days after admission to the unit), multivariable adjustment with Cox modeling showed that transfusion had no association with mortality for the first 2 intervals (0-30 and 31-180 days), but was associated with a 25% lower risk of death (hazard ratio, 0.75; 95% confidence interval, 0.57-0.99; P = .04) in patients who survived at least 180 days after admission to the unit. In the case-control patients, after correction for APACHE II risk of death and propensity to receive a transfusion, transfusion had no association with mortality for the first 2 intervals, but was associated with 29% lowered risk of death (hazard ratio, 0.71; 95% confidence interval, 0.50-0.99; P = .046). Conclusion Blood transfusion was associated with a decreased risk of late (>180 days) death in intensive care patients. (American Journal of Critical Care. 2009;18:124-132) Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your under standing of the following objectives: 1. Describe the effect of erythrocyte blood transfusion in the intensive care unit on long-term survivability.2. Discuss the differences between the Cox proportional hazard modeling and the KaplanMeier survival curve.3. Integrate findings of the research study into nursing practice in the intensive care unit.

show abstract

Section: Discussionsupporting

confidence: 86%

Long-term Survival in the Intensive Care Unit After Erythrocyte Blood Transfusion

Engoren

Arslanian‐Engoren

2009

American Journal of Critical Care

View full text Add to dashboard Cite

show abstract

“…Analysis below 8.0 g/dL could not be undertaken due to small sample size. 13 These data suggest that the human body may be more resilient than previously believed and that blood transfusion may not be necessary until (and if) severe anemia presents.…”

Section: Discussionmentioning

confidence: 85%

Blood Transfusion and In-hospital Outcomes in Anemic Patients with Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Jani

Smith

et al. 2007

Clin Cardiol

View full text Add to dashboard Cite

SummaryStudies have shown poor prognostic implications of anemia in patients with myocardial infarction (MI) and in patients undergoing percutaneous coronary intervention (PCI). The impact of blood transfusion in these populations remains controversial. The objective of this study was to examine the effect of transfusion on in-hospital mortality in anemic patients undergoing PCI for MI.Data from 67,051 PCIs (June 1, 1997 to January 31, 2004) were prospectively collected in a multicenter registry (Blue Cross Blue Shield of Michigan Cardiovascular Consortium). Of these, 4,623 patients who were classified as anemic according to the World Health Organization criteria underwent PCI within 7 days of presentation with acute MI. A propensity score for being transfused was estimated for each patient, and propensity matching and a prediction model for in-hospital death were developed.The average age was 67.8 years, 57.7% of patients were men, and 22.3% of patients received a transfusion during hospitalization. Transfused patients, compared to nontransfused patients, were more likely to be older, female, have lower preprocedure hemoglobin levels, more comorbidities, and a higher unadjusted in-hospital mortality rate (14.52% vs. 3.01%, p < 0.0001). After adjustment for comorbidities and propensity for transfusion, blood transfusion was associated with a higher risk of in-hospital mortality (adjusted odds ratio = 2.02, 95% confidence interval 1.47-2.79, p < 0.0001).In anemic patients undergoing PCI for MI, transfusion was associated with an increased crude and adjusted rate of in-hospital mortality. A randomized controlled trial is needed to determine the value of transfusion and the ideal transfusion criteria.

show abstract

“…Distinguishing the role of admission hemoglobin is of major importance, since hemoglobin values at different time points of the perioperative period may indicate different problems, and have consequently different clinical implications. Knowing the risks of blood transfusion it is of even more importance to recognize if and at which level hemoglobin at admission is related to outcome, as to decide when transfusion becomes justifiable [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Is anemia at admission related to short-term outcomes of elderly hip fracture patients?

Dubljanin-Raspopovic¹,

Marković-Denić

Nikolić

et al. 2011

Open Medicine

View full text Add to dashboard Cite

AbstractHip fracture in elderly people is associated with high morbidity and mortality. Therefore, it is important to identify risk factors that potentially influence outcomes after hip surgery. The main purpose of this study was to evaluate the relationship of anemia at admission and short-term outcomes after hip fracture. We studied 343 community-dwelling patients who underwent surgery for hip fracture from March 2009 to March 2010. Functional mobility at discharge, postoperative complications, hospital length of stay and in-hospital mortality were analyzed in respect to presence and severity of anemia at admission. Anemia (defined as hemoglobin levels < 13.0 g/dl for men and < 12.0g/dl for women) was present in 185 (53.9%) patients, of whom 54 (29.2%) were severely anemic (defined as hemoglobin level 10.0g/dl or below). In multivariate analysis anemia was associated with age, gender (female), type of fracture (intertrochanteric) and American Society of Anesthesiologists (ASA) classification (3 or 4), while severity of anemia was associated with recovery of ambulatory ability at discharge. There was no difference in the incidence of postoperative complication, in-hospital mortality and length of hospital stay between the groups at discharge. Overall anemia at admission is an indicator of poor general health status. Ambulatory recovery in hip fracture patients is independently related to severity of anemia at admission.

show abstract

Perioperative Blood Transfusion and Postoperative Mortality

Cited by 24 publications

References 15 publications

Long-term Survival in the Intensive Care Unit After Erythrocyte Blood Transfusion

Long-term Survival in the Intensive Care Unit After Erythrocyte Blood Transfusion

Blood Transfusion and In-hospital Outcomes in Anemic Patients with Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Is anemia at admission related to short-term outcomes of elderly hip fracture patients?

Contact Info

Product

Resources

About