美国四个地区输血受者的人口统计学和流行病学特征：来自REDS-III受者数据库的证据
Demographic and epidemiologic characterization of transfusion recipients from four US regions: evidence from the REDS-III recipient database.
作者信息
Karafin Matthew S, Bruhn Roberta, Westlake Matt, Sullivan Marian T, Bialkowski Walter, Edgren Gustaf, Roubinian Nareg H, Hauser Ronald G, Kor Daryl J, Fleischmann Debra, Gottschall Jerome L, Murphy Edward L, Triulzi Darrell J
机构信息
BloodCenter of Wisconsin (BCW), Milwaukee, Wisconsin.
Blood Systems Research Institute, University of California San Francisco, San Francisco, California.
出版信息
Transfusion. 2017 Dec;57(12):2903-2913. doi: 10.1111/trf.14370. Epub 2017 Oct 24.
BACKGROUND
Blood transfusion is one of the most common medical procedures during hospitalization in the United States. To understand the benefits of transfusion while mitigating potential risks, a multicenter database containing detailed information on transfusion incidence and recipient outcomes would facilitate research.
STUDY DESIGN AND METHODS
The Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) program has developed a comprehensive transfusion recipient database utilizing data from hospital electronic health records at 12 participating hospitals in four geographic regions. Inpatient and outpatient data on transfusion recipients from January 1, 2013 to December 31, 2014 included patient age, sex, ethnicity, primary diagnosis, type of blood product provided, issue location, pretransfusion and post-transfusion hemoglobin (Hgb), and hospital outcomes. Transfusion incidence per encounter was calculated by blood product and various patient characteristics.
RESULTS
During the 2-year study period, 80,362 (12.5%) inpatient encounters involved transfusion. Among inpatients, the most commonly transfused blood products were red blood cells (RBCs; 10.9% of encounters), followed by platelets (3.2%) and plasma (2.9%). Among patients who received transfusions, the median number of RBC units was one, the pretransfusion Hgb level was 7.6 g/dL, and the Hgb increment per unit was 1.4 g/dL. Encounter mortality increased with patient age, the number of units transfused, and the use of platelet or plasma products. The most commonly reported transfusion reaction was febrile nonhemolytic.
CONCLUSION
The database contains comprehensive data regarding transfusion use and patient outcomes. The current report describes an evaluation of the first 2 years of a planned, 4-year, linked blood donor-component-recipient database, which represents a critical new resource for transfusion medicine researchers.
背景
输血是美国住院期间最常见的医疗程序之一。为了了解输血的益处同时降低潜在风险，一个包含输血发生率和受血者结局详细信息的多中心数据库将有助于开展研究。
研究设计与方法
受血者流行病学与供者评估研究III（REDS-III）项目利用来自四个地理区域12家参与医院的医院电子健康记录数据，开发了一个全面的输血受血者数据库。2013年1月1日至2014年12月31日期间输血受血者的住院和门诊数据包括患者年龄、性别、种族、主要诊断、提供的血液制品类型、发放地点、输血前和输血后血红蛋白（Hgb）以及医院结局。每次就诊的输血发生率按血液制品和各种患者特征进行计算。
结果
在为期2年的研究期间，80362例（12.5%）住院患者接受了输血。在住院患者中，最常输注的血液制品是红细胞（RBCs；占就诊病例的10.9%），其次是血小板（3.2%）和血浆（2.9%）。在接受输血的患者中，红细胞单位的中位数为1个，输血前Hgb水平为7.6 g/dL，每单位Hgb增加量为1.4 g/dL。就诊死亡率随患者年龄、输注单位数以及血小板或血浆制品的使用而增加。最常报告的输血反应是发热性非溶血性反应。
结论
该数据库包含有关输血使用和患者结局的全面数据。本报告描述了对一个计划为期4年的、关联献血者-成分-受血者数据库头两年的评估，该数据库是输血医学研究人员的一项重要新资源。
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