输血导致循环负荷过重的死亡率相关风险因素。

IF 1.8 4区医学 Q3 HEMATOLOGY Vox Sanguinis Pub Date : 2024-09-01 Epub Date: 2024-06-13 DOI:10.1111/vox.13690

Lipika Soni, Samia Saeed, Christine Cserti-Gazdewich, Mark J McVey

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引用次数: 0

摘要

背景和目的：呼吸道输血反应与发病率和死亡率密切相关，输血相关循环负荷过重（TACO）是输血反应相关死亡的主要原因。TACO的风险因素包括输血速度、输血量和心肾合并症：采用单变量和多变量回归分析法，对一个学术健康网络的血液警戒数据库进行了查询，以评估与371例TACO和参与就诊结果相关的变量：11年间，179名男性和192名女性发生了TACO反应，中位年龄（四分位间距）为65（53-75）岁。住院死亡率和 28 天死亡率分别为 17.5% 和 12.9%。在单变量回归模型中，男性性别、损伤严重程度分级、给药量、血小板使用量和重症监护入院率均与住院和 28 天死亡率相关（p 结论：在该队列中，男性受者、血小板使用量和重症监护入院率均与住院和 28 天死亡率相关：在该队列中，男性受体性别和血小板用量与涉及 TACO 的入院治疗相关，但并不影响存活率。

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Mortality-associated risk factors for transfusion-associated circulatory overload.

Background and objectives: Respiratory transfusion reactions associate strongly with morbidity and mortality, and transfusion-associated circulatory overload (TACO) is the leading cause of reaction-related deaths. Risk factors for TACO include transfusion speed and volume and cardiorenal comorbidities.

Materials and methods: An academic health network haemovigilance database was interrogated to assess variables associating with 371 cases of TACO and involved-visit outcomes, using univariate and multivariate regression analysis.

Results: TACO reactions over 11 years were reported in 179 males and 192 females, median age (interquartile range) 65 (53-75) years. In-hospital and 28-day mortality were 17.5% and 12.9%, respectively. In univariate regression modelling, male sex, injury severity grade, product volume administered, the use of platelets and intensive care admissions were each associated with in-hospital and 28-day mortality (p < 0.05). However, after multivariate regression analysis, only male sex in transfusion recipients independently associated with mortality (p < 0.05).

Conclusion: In this cohort, male recipient sex and platelet administration were associated with TACO-involving admissions not ending in survival.

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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.