颅内动脉瘤性和脑内出血患者的术前贫血和红细胞输血-德国 PBM 网络注册中心的一项多中心亚分析。
Preoperative anaemia and red blood cell transfusion in patients with aneurysmal subarachnoid and intracerebral haemorrhage - a multicentre subanalysis of the German PBM Network Registry.
机构信息
Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
Institute of Biostatistics and Mathematical Modelling, Department of Medicine, Goethe University, Frankfurt, Germany.
出版信息
Acta Neurochir (Wien). 2022 Apr;164(4):985-999. doi: 10.1007/s00701-022-05144-7. Epub 2022 Feb 26.
PURPOSE
Anaemia is common in patients presenting with aneurysmal subarachnoid (aSAH) and intracerebral haemorrhage (ICH). In surgical patients, anaemia was identified as an idenpendent risk factor for postoperative mortality, prolonged hospital length of stay (LOS) and increased risk of red blood cell (RBC) transfusion. This multicentre cohort observation study describes the incidence and effects of preoperative anaemia in this critical patient collective for a 10-year period.
METHODS
This multicentre observational study included adult in-hospital surgical patients diagnosed with aSAH or ICH of 21 German hospitals (discharged from 1 January 2010 to 30 September 2020). Descriptive, univariate and multivariate analyses were performed to investigate the incidence and association of preoperative anaemia with RBC transfusion, in-hospital mortality and postoperative complications in patients with aSAH and ICH.
RESULTS
A total of n = 9081 patients were analysed (aSAH n = 5008; ICH n = 4073). Preoperative anaemia was present at 28.3% in aSAH and 40.9% in ICH. RBC transfusion rates were 29.9% in aSAH and 29.3% in ICH. Multivariate analysis revealed that preoperative anaemia is associated with a higher risk for RBC transfusion (OR = 3.25 in aSAH, OR = 4.16 in ICH, p < 0.001), for in-hospital mortality (OR = 1.48 in aSAH, OR = 1.53 in ICH, p < 0.001) and for several postoperative complications.
CONCLUSIONS
Preoperative anaemia is associated with increased RBC transfusion rates, in-hospital mortality and postoperative complications in patients with aSAH and ICH.
TRIAL REGISTRATION
ClinicalTrials.gov , NCT02147795, https://clinicaltrials.gov/ct2/show/NCT02147795.
目的
贫血在蛛网膜下腔出血（aSAH）和脑出血（ICH）患者中很常见。在手术患者中，贫血被确定为术后死亡、住院时间延长（LOS）和增加红细胞（RBC）输血风险的独立危险因素。本多中心队列观察研究描述了在这一关键患者群体中，10 年内术前贫血的发生率和影响。
方法
本多中心观察性研究纳入了 21 家德国医院（2010 年 1 月 1 日至 2020 年 9 月 30 日出院）住院手术患者中诊断为 aSAH 或 ICH 的成年患者。进行描述性、单变量和多变量分析，以研究 aSAH 和 ICH 患者术前贫血与 RBC 输血、住院死亡率和术后并发症的发生率和相关性。
结果
共分析了 n = 9081 例患者（aSAH n = 5008；ICH n = 4073）。aSAH 术前贫血发生率为 28.3%，ICH 为 40.9%。RBC 输血率分别为 aSAH 的 29.9%和 ICH 的 29.3%。多变量分析显示，术前贫血与 RBC 输血风险增加相关（aSAH 的 OR = 3.25，ICH 的 OR = 4.16，p < 0.001），与住院死亡率相关（aSAH 的 OR = 1.48，ICH 的 OR = 1.53，p < 0.001），与术后多种并发症相关。
结论
术前贫血与 aSAH 和 ICH 患者 RBC 输血率增加、住院死亡率和术后并发症相关。
试验注册
ClinicalTrials.gov，NCT02147795，https://clinicaltrials.gov/ct2/show/NCT02147795。
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