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2003-2017 年瑞典产科实践中红细胞输注使用模式:一项全国性研究。

Patterns of red-cell transfusion use in obstetric practice in sweden 2003-2017: A nationwide study.

机构信息

Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.

Department of Anaesthesiology and Intensive Care, Södersjukhuset, Stockholm, Sweden.

出版信息

Vox Sang. 2021 Aug;116(7):821-830. doi: 10.1111/vox.13074. Epub 2021 Feb 2.

Abstract

BACKGROUND

There is a paucity of data on patterns of red-cell transfusions in obstetrical care, but some studies have suggested an increase in transfusion rates during the last decade. The purpose of this study was to investigate maternal characteristics, temporal trends and hospital variations in red-cell use in a large contemporary obstetric cohort in Sweden.

STUDY DESIGN AND METHODS

Nationwide observational cohort study of maternal red-cell transfusions for all deliveries in Sweden between 2003 and 2017.

RESULTS

The proportion of deliveries that received red-cell transfusions was stable during the study period, although the number of red-cell units administered per delivery declined. Among transfused women, most received a low-volume transfusion of 1 or 2 units. Red-cell transfusion was more common among the nulliparous, for instrumental and caesarean deliveries, and with increased maternal age. We saw large variations in transfusion rates between hospitals in Sweden, despite adjusting for age and parity.

CONCLUSIONS

In comparison to other high-resource countries we see a high proportion of deliveries with maternal red-cell transfusions. However, we do not see an increase in red-cell use over time.

摘要

背景

产科护理中红细胞输血模式的数据很少,但一些研究表明,在过去十年中,输血率有所增加。本研究的目的是调查瑞典一个大型当代产科队列中红细胞使用的产妇特征、时间趋势和医院差异。

研究设计和方法

对 2003 年至 2017 年期间瑞典所有分娩的产妇红细胞输血进行了全国性观察性队列研究。

结果

尽管每次分娩输注的红细胞单位数有所下降,但研究期间接受红细胞输血的分娩比例保持稳定。在接受输血的女性中,大多数接受了 1 或 2 单位的低剂量输血。初产妇、器械分娩和剖宫产分娩以及产妇年龄增加的情况下,输血更为常见。尽管调整了年龄和产次,但我们发现瑞典各医院的输血率存在很大差异。

结论

与其他高资源国家相比,我们看到有大量的分娩需要进行产妇红细胞输血。然而,我们并没有看到红细胞使用量随时间的增加而增加。

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