Flint Andrew, Aubron Cécile, Bailey Michael, Bellomo Rinaldo, Pilcher David, Cheng Allen C, Hegarty Colin, Reade Michael C, McQuilten Zoe
The Australian and New Zealand Intensive Care Research Centre.
Royal Australian Navy, Australian Defence Force, Canberra, Australia.
Transfusion. 2017 Mar;57(3):599-605. doi: 10.1111/trf.14056.
The storage duration of platelet (PLT) units is limited to 5 to 7 days. This study investigates whether PLT storage duration is associated with patient outcomes in critically ill patients.
This study was a retrospective analysis of critically ill patients admitted to the intensive care unit (ICU) of two hospitals in Australia who received one or more PLT transfusions from 2008 to 2014. Storage duration was approached in several different ways. Outcome variables were hospital mortality and ICU-acquired infection. Associations between PLT storage duration and outcomes were evaluated using multiple logistic regression and also by Cox regression.
Among 2250 patients who received one or more PLT transfusions while in the ICU, the storage duration of PLTs was available for 64% of patients (1430). In-hospital mortality was 22.1% and ICU infection rate 7.2%. When comparing patients who received PLTs of a maximum storage duration of not more than 3, 4, or 5 days, there were no significant differences in baseline characteristics. After confounders were adjusted for, the storage duration of PLTs was not independently associated with mortality (4 days vs. ≤3 days, odds ratio [OR] 0.88, 95% confidence interval [CI] 0.59-1.30; 5 days vs. ≤3 days, OR 0.97, 95% CI 0.68-1.37) or infection (4 days vs. ≤3 days, OR 0.71, 95% CI 0.39-1.29; 5 days vs. ≤3 days, OR 1.11, 95% CI 0.67-1.83). Similar results were obtained regardless of how storage duration of PLTs was approached.
In this large observational study in a heterogeneous ICU population, storage duration of PLTs was not associated with an increased risk of mortality or infection.
血小板（PLT）单位的储存期限限制为5至7天。本研究调查了PLT储存期限是否与危重症患者的预后相关。
本研究是对2008年至2014年期间在澳大利亚两家医院重症监护病房（ICU）接受一次或多次PLT输血的危重症患者进行的回顾性分析。以几种不同方式处理储存期限。结局变量为医院死亡率和ICU获得性感染。使用多元逻辑回归和Cox回归评估PLT储存期限与结局之间的关联。
在2250例在ICU期间接受一次或多次PLT输血的患者中，64%（1430例）患者的PLT储存期限数据可用。住院死亡率为22.1%，ICU感染率为7.2%。比较接受最大储存期限不超过3天、4天或5天的PLT的患者时，基线特征无显著差异。在对混杂因素进行调整后，PLT的储存期限与死亡率（4天与≤3天相比，比值比[OR]0.88，95%置信区间[CI]0.59 - 1.30；5天与≤3天相比，OR 0.97，95% CI 0.68 - 1.37）或感染（4天与≤3天相比，OR 0.71，95% CI 0.39 - 1.29；5天与≤3天相比，OR 1.11，95% CI 0.67 - 1.83）均无独立关联。无论如何处理PLT的储存期限，均获得类似结果。
在这项针对异质性ICU人群的大型观察性研究中，PLT的储存期限与死亡率或感染风险增加无关。
