Effects of transfusing older red blood cells on patient outcomes in critical illness: A retrospective cohort study.

IF 1.8 4区医学 Q3 HEMATOLOGY

Vox Sanguinis Pub Date : 2025-03-03 DOI:10.1111/vox.70007

Nchafatso G Obonyo, Declan P Sela, Nicole White, Matthew Tunbridge, Beatrice Sim, Reema H Rachakonda, Louise E See Hoe, Gianluigi Li Bassi, Jonathon P Fanning, John-Paul Tung, Jacky Y Suen, John F Fraser

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引用次数: 0

Abstract

Background and objectives: Randomized controlled trials have demonstrated morbidity and mortality in critically ill patients are unaffected by transfusing fresh (<7 days old) packed red blood cells (pRBCs); however, there is limited evidence regarding transfusion with pRBCs nearing expiry (35-42 days). The aim of this study was to investigate the effects of transfusing pRBCs close to the end of shelf life (≥35 days) on clinical outcomes in critically ill patients.

Materials and methods: A retrospective observational analysis of data obtained from centralized electronic medical records (2007-2013), sourced from all public and licensed private hospitals in Queensland, Australia, with intensive care units. Multivariate logistic and linear regressions were used to analyse association between transfusion with pRBCs nearing expiry, and in-hospital mortality, hospital length of stay (HLOS) and rate of discharge home. Comparisons are presented as odds ratios (ORs) with 95% confidence intervals (CIs).

Results: The study included 10,350 critically ill adult patients transfused ≥1 unit of non-irradiated pRBCs (64,594 pRBCs units transfused). Receiving at least 1-unit pRBCs ≥ 35 days old was associated with increased mortality (OR 1.21 [95% CI 1.06-1.38]; p = 0.005), decreased discharge to usual residence (OR 0.81 [95% CI 0.73-0.89]; p < 0.0001) and increased hospital LOS (estimate 2.55 [95% CI 1.60-3.49]; p < 0.0001). There was also association with increased sepsis (OR 1.27 [95% CI 1.13-1.42]; p < 0.0001) and delirium (OR 1.25 [95% CI 1.06-1.49]; p = 0.01).

Conclusion: Transfusion of ≥1-unit pRBCs ≥ 35 days old was associated with higher morbidity and mortality in critically ill patients.

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来源期刊

Vox Sanguinis 医学-血液学

CiteScore

4.40

自引率

11.10%

发文量

156

审稿时长

6-12 weeks

期刊介绍： Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections: 1) Transfusion - Transmitted Disease and its Prevention: Identification and epidemiology of infectious agents transmissible by blood; Bacterial contamination of blood components; Donor recruitment and selection methods; Pathogen inactivation. 2) Blood Component Collection and Production: Blood collection methods and devices (including apheresis); Plasma fractionation techniques and plasma derivatives; Preparation of labile blood components; Inventory management; Hematopoietic progenitor cell collection and storage; Collection and storage of tissues; Quality management and good manufacturing practice; Automation and information technology. 3) Transfusion Medicine and New Therapies: Transfusion thresholds and audits; Haemovigilance; Clinical trials regarding appropriate haemotherapy; Non-infectious adverse affects of transfusion; Therapeutic apheresis; Support of transplant patients; Gene therapy and immunotherapy. 4) Immunohaematology and Immunogenetics: Autoimmunity in haematology; Alloimmunity of blood; Pre-transfusion testing; Immunodiagnostics; Immunobiology; Complement in immunohaematology; Blood typing reagents; Genetic markers of blood cells and serum proteins: polymorphisms and function; Genetic markers and disease; Parentage testing and forensic immunohaematology. 5) Cellular Therapy: Cell-based therapies; Stem cell sources; Stem cell processing and storage; Stem cell products; Stem cell plasticity; Regenerative medicine with cells; Cellular immunotherapy; Molecular therapy; Gene therapy.