ABO 和 RhD 血型与危重症患者的死亡率和发病率无关；一项对 29512 例患者的多中心观察性研究。
ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients.
机构信息
Anaesthesia & Intensive Care, Department of Clinical Sciences, Lund University, Skåne University Hospital, Entrégatan 7, 222 42, Lund, Sweden.
Clinical Immunology and Transfusion Medicine, Laboratory Medicine, Office for Medical Services, Region Skåne, Lund, Sweden.
出版信息
BMC Anesthesiol. 2022 Apr 2;22(1):91. doi: 10.1186/s12871-022-01626-4.
BACKGROUND
The ABO and RhD blood group represent antigens on the surface of erythrocytes. The ABO blood group antigens are also present on multiple other cells. Interestingly, previous studies have demonstrated associations between the blood group and many types of disease. The present study aimed to identifying associations between the ABO blood group, the RhD blood group, and morbidity and mortality in a mixed cohort and in six pre-defined subgroups of critically ill patients.
METHODS
Adult patients admitted to any of the five intensive care units (ICUs) in the Scania Region, Sweden, between February 2007 and April 2021 were eligible for inclusion. The outcomes were mortality analysed at 28- and 90-days as well as at the end of observation and morbidity measured using days alive and free of (DAF) invasive ventilation (DAF ventilation) and DAF circulatory support, including vasopressors or inotropes (DAF circulation), maximum Sequential Organ Failure Assessment score (SOFAmax) the first 28 days after admission and length of stay. All outcomes were analysed in separate multivariable regression models adjusted for age and sex. In addition, in a sensitivity analysis, five subgroups of patients with the main diagnoses sepsis, septic shock, acute respiratory distress syndrome, cardiac arrest and trauma were analysed using the same separate multivariable regression models.
RESULTS
In total, 29,512 unique patients were included in the analyses. There were no significant differences for any of the outcomes between non-O blood groups and blood group O, or between RhD blood groups. In the sensitivity analysis of subgroups, there were no differences in mortality between non-O blood groups and blood group O or between the RhD blood groups. AB was the most common blood group in the COVID-19 cohort.
CONCLUSIONS
The ABO and RhD blood group do not influence mortality or morbidity in a general critically ill patient population.
背景
ABO 和 RhD 血型代表红细胞表面的抗原。ABO 血型抗原也存在于多种其他细胞上。有趣的是，先前的研究已经证明了血型与许多类型疾病之间存在关联。本研究旨在确定 ABO 血型、RhD 血型与混合队列和六个预先定义的危重病患者亚组的发病率和死亡率之间的关联。
方法
符合条件的患者为 2007 年 2 月至 2021 年 4 月期间在瑞典斯科讷地区的五个重症监护病房（ICU）之一入院的成年患者。主要结局为 28 天和 90 天以及观察期末的死亡率，以及使用存活且无（DAF）有创通气（DAF 通气）和 DAF 循环支持（包括升压药或正性肌力药）的天数（DAF 循环）、入院后前 28 天的最大序贯器官衰竭评估评分（SOFAmax）和住院时间来衡量发病率。所有结局均在调整年龄和性别后的单独多变量回归模型中进行分析。此外，在敏感性分析中，使用相同的单独多变量回归模型分析了主要诊断为脓毒症、感染性休克、急性呼吸窘迫综合征、心搏骤停和创伤的五个患者亚组的结局。
结果
共纳入 29512 名患者进行分析。非 O 血型与 O 型血或 RhD 血型之间在任何结局上均无显著差异。在亚组的敏感性分析中，非 O 血型与 O 型血或 RhD 血型之间的死亡率也没有差异。AB 是 COVID-19 队列中最常见的血型。
结论
ABO 和 RhD 血型不影响一般危重病患者人群的死亡率或发病率。
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