Warner Matthew A, Woodrum David, Hanson Andrew, Schroeder Darrell R, Wilson Gregory, Kor Daryl J
Department of Anesthesiology.
Department of Vascular & Interventional Radiology, Mayo Clinic, Rochester, Minnesota.
Transfusion. 2017 Apr;57(4):890-898. doi: 10.1111/trf.13996. Epub 2017 Jan 28.
Platelet (PLT) transfusion before interventional radiology procedures is commonly performed in patients with thrombocytopenia. However, it is unclear if PLT transfusion is associated with reduced bleeding complications.
This is a retrospective cohort study of adults undergoing interventional radiology procedures between January 1, 2009, and December 31, 2013. Baseline characteristics, coagulation variables, transfusion requirements, and procedural details were evaluated. Propensity-matched analyses were used to assess relationships between PLT transfusions and the outcomes of interest, including a primary outcome of periprocedural red blood cell (RBC) transfusion during the procedure or within the first 24 hours after procedure.
A total of 18,204 participants met inclusion criteria, and 2060 (11.3%) had a PLT count of not more than 100 × 10 /L before their procedure. Of these, 203 patients (9.9) received preprocedural PLTs. There was no significant difference in RBC requirements between those receiving or not receiving preprocedural PLTs in propensity-matched analysis (odds ratio [OR], 1.45; 95% confidence interval [CI], 0.95-2.21; p = 0.085). PLT transfusion was associated with increased rates of intensive care unit admission (OR [95% CI], 1.57 [1.07-2.32]; p = 0.022).
In patients with thrombocytopenia undergoing interventional radiology procedures, preprocedural PLT transfusion was not associated with reduced periprocedural RBC requirements. These findings suggest that prophylactic PLT transfusions are not warranted in nonbleeding patients with preprocedural PLT counts exceeding 50 × 10 /L. Future clinical trials are needed to further define relationships between prophylactic PLT administration and bleeding complications, especially at more severe levels of thrombocytopenia or in the presence of PLT dysfunction.
血小板减少症患者在介入放射学操作前通常会进行血小板（PLT）输注。然而，尚不清楚PLT输注是否与出血并发症减少相关。
这是一项对2009年1月1日至2013年12月31日期间接受介入放射学操作的成年人进行的回顾性队列研究。评估了基线特征、凝血变量、输血需求和操作细节。倾向匹配分析用于评估PLT输注与感兴趣的结局之间的关系，包括操作期间或操作后24小时内围手术期红细胞（RBC）输注的主要结局。
共有18204名参与者符合纳入标准，其中2060名（11.3%）在操作前血小板计数不超过100×10⁹/L。其中，203名患者（9.9%）接受了操作前PLT。倾向匹配分析显示，接受或未接受操作前PLT的患者之间红细胞需求无显著差异（优势比[OR]，1.45；95%置信区间[CI]，0.95 - 2.21；p = 0.085）。PLT输注与重症监护病房入住率增加相关（OR[95%CI]，1.57[1.07 - 2.32]；p = 0.022）。
在接受介入放射学操作的血小板减少症患者中，操作前PLT输注与围手术期红细胞需求减少无关。这些发现表明，对于操作前血小板计数超过50×10⁹/L的非出血患者，无需进行预防性PLT输注。未来需要进行临床试验，以进一步明确预防性PLT给药与出血并发症之间的关系，尤其是在血小板减少更严重或存在血小板功能障碍的情况下。
