老年危重COVID-19患者贫血和输血与死亡率的关系——来自前瞻性COVIP研究的结果

IF 2.1 4区医学 Q3 HEMATOLOGY

Clinical hemorheology and microcirculation Pub Date : 2023-01-01 DOI:10.3233/CH-231790

Ralf Erkens, Dragos Duse, Bernhard Wernly, Hans Flaatten, Jesper Fjølner, Raphael Romano Bruno, Georg Wolff, Antonio Artigas, Malte Kelm, Michael Beil, Sigal Sviri, Stefan J Schaller, Kristina Fuest, Wojciech Szczeklik, Kerstin Piayda, Muhammed Elhadi, Michael Joannidis, Helene Korvenius Nedergaard, Sandra Oeyen, Rui Moreno, Susannah Leaver, Dylan W de Lange, Bertrand Guidet, Christian Jung

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引用次数: 0

摘要

目的:贫血常见于老年人和危重病人。年龄增加与COVID-19感染后的死亡率升高有关，使老年患者容易出现不良预后。我们调查了老年重症COVID-19患者入院时的贫血或输血需求是否与90天死亡率相关。方法:在这项前瞻性多中心研究中，分析138个重症监护病房(ICU)治疗≥70岁的COVID-19患者的90天死亡率。评估了ICU入院和出院时贫血(WHO定义)与使用红细胞(RBC)输注与死亡率之间的关系。记录老年危重患者红细胞输注血红蛋白阈值。结果:在493例患者(350例贫血，143例非贫血)中，ICU入院时的贫血(WHO定义)与总生存期受损无关。ICU出院时输血和严重贫血(血红蛋白≤10 g/dL)与较高的90天死亡率独立相关。结论:重症老年COVID-19危重患者出院时需要输血和严重贫血与90天死亡率独立相关，而入院时不需要输血和严重贫血。

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Associations of anemia and blood transfusions with mortality in old, critically ill COVID-19 patients - Results from the prospective COVIP Study.

Aims: Anemia is common in the old and often observed in critically ill patients. Increased age is associated with higher mortality following a COVID-19 infection, making old patients prone to poor outcomes. We investigated whether anemia at admission to the ICU or the need for blood transfusion was associated with 90-day mortality in older, critically ill COVID-19 patients.

Methods: In this prospective multicenter study, the 90-day mortality of COVID-19 patients≥70 years treated in 138 intensive care units (ICU) was analyzed. Associations between anemia (WHO definition) at admission and discharge from ICU and the use of red blood cell (RBC) transfusions with mortality were assessed. Hemoglobin thresholds of RBC transfusions in old, critically ill COVID-19 patients were recorded.

Results: In 493 patients (350 anemic, 143 non-anemic), anemia (WHO definition) at the time of ICU admission was not associated with impaired overall survival. Transfusion and severe anemia (hemoglobin≤10 g/dL) at ICU discharge were independently associated with a higher risk of 90-day mortality.

Conclusion: The need for red blood cell transfusions and severe anemia at ICU discharge, but not at the timepoint of admission, were independently associated with 90-day mortality in critically-ill old COVID-19 patients.

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来源期刊

Clinical hemorheology and microcirculation 医学-外周血管病

CiteScore

4.30

自引率

33.30%

发文量

170

期刊介绍： Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research. The endeavour of the Editors-in-Chief and publishers of Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process. Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.