Shaanxi Provincial Cancer Hospital Pathology Department, 710068, China.
Shaanxi Provincial Cancer Hospital Transfusion Department, 710068, China.
Comput Math Methods Med. 2022 Jun 15;2022:4968754. doi: 10.1155/2022/4968754. eCollection 2022.
To investigate the effect of logistic multivariate analysis on the survival rate of advanced malignant tumors and to evaluate the effect of erythrocyte storage injury on the survival rate of advanced malignant tumors and its clinical significance.
A retrospective analysis was performed on 120 advanced cancer patients who received blood transfusion in Shaanxi Cancer Hospital from March 2018 to June 2019, and the risk factors for death were analyzed. A total of 72 advanced cancer patients admitted to hospital from March 2019 to June 2021 were included in the study. The patients with red blood cell transfusion storage time ≤ 14 d were the study group ( = 36), and the patients with red blood cell transfusion storage time > 14 d were the control group ( = 36). Compare the total efficiency of blood transfusion. The levels of Hb, erythrocyte count, hematocrit (HCT), blood oxygen saturation (SPO2), creatinine (Cr), erythrocyte deformability index, whole blood, erythrocyte, and hemoglobin before and after blood transfusion were compared, and the adverse reactions of blood transfusion were recorded.
Dyspnea and delirium were significantly associated with patient survival time ( < 0.05). Red blood cell storage time ≤ 14 days, Lym% < 12%, lactate dehydrogenase (LDH) > 500 U/L, and ALB < 30 g/L were significantly correlated with survival time. Karnofsky performance status (KPS) < 30, delirium, LDH > 500 U/L, and albumin (ALB) < 30 g/L were independent influencing factors of survival ( < 0.05). The overall effective rate of the research group was higher ( < 0.05). The incidence of adverse reactions in the study group was lower ( < 0.05). The levels of Hb, red blood cell count, and HCT in the study group were higher ( < 0.05). Compared with the control group, the SPO2 level and the red blood cell deformability index were higher in the study group ( < 0.05). After blood transfusion, the level of (diphosphoglycerate) DPG in the study group was higher than that in the control group ( < 0.05). The length of hospital stay in the study group was significantly shortened ( < 0.05). The nosocomial infection rate and case fatality rate in the study group were significantly reduced ( < 0.05).
Red blood cell storage time ≤ 14 d, LYM% < 12%, LDH > 500 U/L, and ALB < 30 g/L are all significantly correlated with survival time. KPS < 30, delirium, LDH > 500 U/L, and ALB < 30 g/L were independent factors for survival ( < 0.05). Transfusion of red blood cells stored for ≤14 days in patients with advanced malignant tumors can significantly increase the effective infusion rate, improve anemia status, shorten hospital stay, and reduce mortality and risk of nosocomial infection and is worthy of clinical promotion.
探讨 logistic 多因素分析对晚期恶性肿瘤患者生存率的影响，并评估红细胞储存损伤对晚期恶性肿瘤患者生存率的影响及其临床意义。
回顾性分析 2018 年 3 月至 2019 年 6 月在陕西省肿瘤医院接受输血的 120 例晚期癌症患者的临床资料，分析其死亡的危险因素。选择 2019 年 3 月至 2021 年 6 月期间我院收治的 72 例接受红细胞输注储存时间≤14 d 的晚期癌症患者作为研究组（n=36），将红细胞输注储存时间>14 d 的患者作为对照组（n=36）。比较两组患者的输血总有效率。比较两组患者输血前后 Hb、红细胞计数、红细胞压积（HCT）、血氧饱和度（SPO2）、血肌酐（Cr）、红细胞变形指数、全血、红细胞、血红蛋白水平，记录输血不良反应。
呼吸困难和意识障碍与患者生存时间显著相关（<0.05）。红细胞储存时间≤14 天、Lym%<12%、乳酸脱氢酶（LDH）>500 U/L、白蛋白（ALB）<30 g/L 与生存时间显著相关。卡氏功能状态（KPS）评分<30、意识障碍、LDH>500 U/L、ALB<30 g/L 是生存的独立影响因素（<0.05）。研究组的总有效率较高（<0.05）。研究组不良反应发生率较低（<0.05）。研究组 Hb、红细胞计数和 HCT 水平较高（<0.05）。与对照组相比，研究组 SPO2 水平和红细胞变形指数较高（<0.05）。研究组输血后（二磷酸甘油）DPG 水平高于对照组（<0.05）。研究组的住院时间明显缩短（<0.05）。研究组的医院感染率和病死率均明显降低（<0.05）。
红细胞储存时间≤14 d、LYM%<12%、LDH>500 U/L、ALB<30 g/L 均与生存时间显著相关。KPS<30、意识障碍、LDH>500 U/L、ALB<30 g/L 是生存的独立影响因素（<0.05）。晚期恶性肿瘤患者输注储存时间≤14 d 的红细胞，可显著提高有效输注率，改善贫血状态，缩短住院时间，降低死亡率和医院感染风险，值得临床推广。
