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Blood transfusion in cardiac surgery is a risk factor for increased hospital length of stay in adult patients

机译:心脏手术中的输血是成人患者住院时间增加的危险因素

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摘要

Abstract Background Allogeneic red blood cell (RBC) transfusion has been proposed as a negative indicator of quality in cardiac surgery. Hospital length of stay (LOS) may be a surrogate of poor outcome in transfused patients. Methods Data from 502 patients included in Transfusion Requirements After Cardiac Surgery (TRACS) study were analyzed to assess the relationship between RBC transfusion and hospital LOS in patients undergoing cardiac surgery and enrolled in the TRACS study. Results According to the status of RBC transfusion, patients were categorized into the following three groups: 1) 199 patients (40%) who did not receive RBC, 2) 241 patients (48%) who received 3 RBC units or fewer (low transfusion requirement group), and 3) 62 patients (12%) who received more than 3 RBC units (high transfusion requirement group). In a multivariable Cox proportional hazards model, the following factors were predictive of a prolonged hospital length of stay: age higher than 65 years, EuroSCORE, valvular surgery, combined procedure, LVEF lower than 40% and RBC transfusion of > 3 units. Conclusion RBC transfusion is an independent risk factor for increased LOS in patients undergoing cardiac surgery. This finding highlights the adequacy of a restrictive transfusion therapy in patients undergoing cardiac surgery. Trial registration Clinicaltrials.gov identifier: NCT01021631 .
机译:摘要背景已提出异体红细胞(RBC)输血作为心脏手术质量的阴性指标。住院时间(LOS)可能是输血患者预后不良的替代指标。方法分析来自502例心脏手术后输血要求(TRACS)研究中的患者的数据,以评估心脏手术患者并参加TRACS研究的RBC输血与医院LOS的关系。结果根据RBC输血状况分为以下三类:1)未接受RBC的199例(40%),2)接受3个或更少RBC(低输血)的241例(48%)需求组),以及3)62例患者(12%)接受了超过3个RBC单位(高输血需求组)。在多变量Cox比例风险模型中,以下因素可预测住院时间的延长:年龄高于65岁,EuroSCORE,瓣膜手术,联合手术,LVEF低于40%和RBC输血≥3个单位。结论RBC输注是心脏手术患者LOS升高的独立危险因素。这一发现凸显了在进行心脏手术的患者中进行限制性输血治疗的适当性。试用注册Clinicaltrials.gov标识符:NCT01021631。

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