| Does the relation between red blood cell transfusion andmortality vary according to transfusion indication? Acase-control study among patients with acute coronarysyndromes. | |
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MedLine Citation:
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PMID: 21169814 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES: Red blood cell (RBC) transfusions are common among patients with acute coronary syndromes (ACS). We sought to determine their impact on mortality according to indication. METHODS: We conducted a case-control analysis of ACSpatients admitted to a single coronary care unit. Transfused patients were matched to nontransfused patients for age, estimated glomerular filtration rate, and nadir hematocrit. Conditional logistic regression analysis was used to determine the independent relationship between RBC transfusion and inhospital mortality. Resultswere stratified according to the indication for transfusion. RESULTS: Of the 3190 patients admitted with ACS, 206 (6.4%) received at least one RBC transfusion. Of these, 103patients were matched to 185 nontransfused patients. The most common indications for transfusion were nonspecific anemia (48%) and overt blood loss (42%). Transfused patients had a significantly lower ejection fraction and were more likely to present in Killip class IV, undergo pulmonary artery catheterization, and require anintra-aortic balloon pump. On univariate analysis, RBCtransfusion was associated with a doubling of theriskof inhospital mortality [odds ratio: 2.0; 95% confidence interval: 1.0-3.9; P=0.046]. However, afteradjustment for confounders, transfusion was no longer significantly associated with higher inhospital mortality (odds ratio: 1.8; 95% confidence interval: 0.6-5.1; P=0.3). On stratified analysis, RBC transfusion was not significantly associated with inhospital mortality among patients transfused for either nonspecific anemia or overtblood loss. CONCLUSIONS: Among coronary care unit patients with ACS,RBC transfusion does not seem to have a significantimpact on inhospital mortality irrespective of theindicationfor transfusion. |
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Authors:
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Chhaya Aggarwal; Julio A Panza; Howard A Cooper |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2010-12-16 |
Journal Detail:
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Title: Coronary artery disease Volume: - ISSN: 1473-5830 ISO Abbreviation: - Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9011445 Medline TA: Coron Artery Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Coronary Care Unit, Washington Hospital Center, Washington DC, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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