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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Red Blood Cell Transfusions and Outcomes After Intracerebral Hemorrhage
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Red Blood Cell Transfusions and Outcomes After Intracerebral Hemorrhage

机译：脑出血后红细胞输血和结果

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摘要

Background: Low red blood cell (RBC) levels are associated with worse intracerebral hemorrhage (ICH) outcomes. However, relationships of RBC transfusions on ICH outcomes are unclear given the overlap of RBC transfusion, comorbidities, and disease severity. We investigated RBC transfusion relationships on ICH outcomes while accounting for comorbidities and disease severity. Methods: ICH hospitalizations between 2002 and 2011 and RBC transfusion exposure were identified from the Nationwide Inpatient Sample using ICD-9-CM codes. Logistic regression was used to study the relationship between RBC transfusion on outcomes after adjusting for demographics, baseline comorbidities, and markers of disease severity. Additional sensitivity analyses stratified by comorbidity burden and disease severity were performed. Results: Of 597,046 ICH hospitalizations, RBC transfusions were administered in 22,904 (4%). RBC transfusion was associated with higher odds of in-hospital mortality (adjusted OR: 1.22 [95%CI: 1.10-1.35]). In sensitivity analyses, RBC transfusions resulted in poor outcomes regardless of the comorbidity burden, but attenuation in this relationship was notable with lower comorbidities (adjusted OR 1.43 [95%CI: 1.34-1.51] vs 1.18 [95%CI: 1.10-1.29]). There were no associations of RBC transfusions with poor outcomes in hospitalizations without mechanical ventilation (adjusted OR 0.88 [95%CI: 0.83-1.13]) and in cases requiring ventriculostomy drains (adjusted OR 1.05 [95%CI: 0.97-1.10]). Conclusions: In a large, nationally representative sample, RBC transfusion was associated with poor ICH outcomes. However, there were variations in this relationship based on comorbidities and disease severity. Additional prospective studies are required to assess direct risks and benefits from RBC transfusions in ICH.
机译：背景：低红细胞（RBC）水平与更糟糕的脑出血（ICH）结局相关。然而，鉴于红细胞输注、共病和疾病严重程度的重叠，红细胞输注与ICH预后的关系尚不清楚。我们调查了红细胞输注与ICH预后的关系，同时考虑了共病和疾病严重程度。方法：使用ICD-9-CM代码，从全国住院患者样本中识别2002年至2011年的ICH住院病例和红细胞输注暴露。在校正人口统计学、基线共病和疾病严重程度标志物后，使用逻辑回归研究红细胞输注与预后之间的关系。根据共病负担和疾病严重程度进行额外的敏感性分析。结果：在597046例ICH住院患者中，22904例（4%）接受了红细胞输注。红细胞输注与较高的院内死亡率相关（调整后的OR:1.22[95%CI:1.10-1.35]）。在敏感性分析中，无论共病负担如何，红细胞输注都会导致不良结果，但这种关系的减弱在共病较低时是显著的（调整后的OR值为1.43[95%CI:1.34-1.51]vs 1.18[95%CI:1.10-1.29]）。在无机械通气的住院患者（调整后的OR 0.88[95%CI:0.83-1.13]）和需要脑室造瘘引流的患者（调整后的OR 1.05[95%CI:0.97-1.10]）中，红细胞输注与不良结局没有关联。结论：在一个具有全国代表性的大样本中，红细胞输注与ICH预后不良相关。然而，基于共病和疾病严重程度，这种关系存在差异。需要额外的前瞻性研究来评估ICH中红细胞输注的直接风险和益处。

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