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输血是否会增加接受单纯冠状动脉旁路移植术的糖尿病患者的死亡率?对816例患者的倾向评分匹配分析。

Did blood transfusion increase mortality in patients with diabetes undergoing isolated coronary artery bypass graft surgery? A propensity score-matched analysis of 816 patients.

作者信息

Koçyiğit Muharrem, Ulugöl Halim, İrem Kıran Seher, Alhan Cem, Toraman Fevzi

机构信息

Department of Anesthesiology and Reanimation, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.

Department of Cardiovascular Surgery, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Oct 21;28(4):586-592. doi: 10.5606/tgkdc.dergisi.2020.19814. eCollection 2020 Oct.

Abstract

BACKGROUND

The aim of this study was to compare clinical outcomes of blood transfusion in patients with diabetes mellitus undergoing isolated on-pump coronary artery bypass grafting.

METHODS

The medical records of a total of 1,912 patients (1,300 males, 612 females; mean age 60.7±10.0) with diabetes who underwent isolated on-pump coronary artery bypass grafting between January 1999 and June 2019 were retrospectively analyzed. The patients were divided into two groups as patients with and without blood transfusions. The mortality rates were compared between the two groups.

RESULTS

The mortality rate was 14 times higher in the patients receiving blood transfusion (odds ratio: 14.80; 95% confidence interval 5.05 to 43.34; p<0.001). However, in the multivariate logistic regression analysis, there were no statistically significant difference in mortality between the patient groups, when diabetes mellitus was a covariate factor (Odds ratio: 8.34; 95% confidence interval 3.94 to 17.66 vs. odds ratio 8.36; 95% confidence interval 3.95 to 17.70).

CONCLUSION

The propensity score-matched analysis of patients with diabetes showed that clinical outcomes were more severely affected by blood transfusion.

摘要

背景

本研究旨在比较接受单纯体外循环冠状动脉旁路移植术的糖尿病患者输血后的临床结局。

方法

回顾性分析1999年1月至2019年6月期间共1912例接受单纯体外循环冠状动脉旁路移植术的糖尿病患者(男性1300例,女性612例;平均年龄60.7±10.0岁)的病历。将患者分为输血组和未输血组,比较两组的死亡率。

结果

输血患者的死亡率高出14倍(比值比:14.80;95%置信区间5.05至43.34;p<0.001)。然而,在多因素逻辑回归分析中,当糖尿病作为协变量因素时,两组患者的死亡率无统计学显著差异(比值比:8.34;95%置信区间3.94至17.66,与比值比8.36;95%置信区间3.95至17.70相比)。

结论

对糖尿病患者进行倾向评分匹配分析表明,输血对临床结局的影响更为严重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09b6/7759041/bdc686cac605/TJTCS-2020-28-4-586-592-F1.jpg

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