Trinh T H C, Fleury M, Leo-Kodeli S, Gauvain J-B
Service de médecine aiguë gériatrique, centre hospitalier régional d'Orléans, hôpital de la Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France.
Service de médecine aiguë gériatrique, centre hospitalier régional d'Orléans, hôpital de la Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France.
Transfus Clin Biol. 2015 Mar;22(1):42-8. doi: 10.1016/j.tracli.2014.12.002. Epub 2015 Jan 31.
Description of the transfusion practice and its specificities in a geriatric unit.
Prospective descriptive study realized by a single consultant.
patients admitted in the unit between 01/10/2011 and 31/01/2012 with hemoglobin level below 10 g/dL.
Eighty-one patients: 87.7-year-old±5.6, ADL 2.1±1.9. CIRS 15.5±3.9. Forty-five (55.5%) of the patients received blood transfusion. Cause of admittance: anemia for 9% of patients. The etiology of anemia was multifactorial in the majority of cases. Admission hemoglobin rate: 9.1 g/dL±1.1 in transfused group versus 9.6 g/dL±0.5 for non-transfused patients. The clinical signs of anemia were asthenia (98.8%), impact on everyday activities (91.4%), respiratory distress (60.5%), stability disturbances and falls (38.3%), confusion (32.1%), hemodynamic disorders (29.6%). The increase of hemoglobin rate was 1.45 g/dL in the transfused group versus 0.3 g/dL for the non-transfused patients. A side effect was observed in 2 transfused patients (4.4%).
Transfusion decision criteria are rarely studied in geriatrics. The clinical signs of anemia include the classical hemodynamic disorders, cardio-respiratory and more specific of the elderly patients as confusion, majoring of cognitive decline and falls. The transfusion threshold (1.4 g/dL per 1 RBC unit) seems higher than in the overall transfused patients. Transfusion remains the fastest way to correct anemia but exposes to circulatory overload.
描述老年病房的输血实践及其特殊性。
由一名顾问进行的前瞻性描述性研究。
2011年10月1日至2012年1月31日期间入住该病房且血红蛋白水平低于10 g/dL的患者。
81例患者，年龄87.7岁±5.6岁，日常生活活动能力评分为2.1±1.9，累积疾病严重程度评分系统（CIRS）评分为15.5±3.9。45例（55.5%）患者接受了输血。入院原因：9%的患者为贫血。大多数情况下，贫血的病因是多因素的。输血组入院时血红蛋白水平为9.1 g/dL±1.1，未输血患者为9.6 g/dL±0.5。贫血的临床症状包括乏力（98.8%）、对日常活动的影响（91.4%）、呼吸窘迫（60.5%）、平衡障碍和跌倒（38.3%）、意识模糊（32.1%）、血流动力学紊乱（29.6%）。输血组血红蛋白水平升高了1.45 g/dL，未输血患者升高了0.3 g/dL。2例输血患者（4.4%）出现了副作用。
老年医学中很少研究输血决策标准。贫血的临床症状包括典型的血流动力学紊乱、心肺方面以及老年患者更具特异性的症状，如意识模糊、认知能力下降加重和跌倒。输血阈值（每1个红细胞单位1.4 g/dL）似乎高于总体输血患者。输血仍然是纠正贫血最快的方法，但存在循环超负荷的风险。
