Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Division of General Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
Int J Clin Pract. 2022 Sep 6;2022:8121611. doi: 10.1155/2022/8121611. eCollection 2022.
Anaemia has a deleterious effect on surgical patients, but the long-term impact of anaemia in critically ill surgical patients remains unclear.
We enrolled consecutive patients who were admitted to surgical intensive care units (ICUs) at a tertiary referral centre in central Taiwan between 2015 and 2020. We used both Cox proportional hazards analysis and propensity score-based analyses, including propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and covariate balancing propensity score (CBPS) to determine hazard ratios (HRs) and 95% confidence intervals (CIs) for one-year mortality.
A total of 7,623 critically ill surgical patients were enrolled, and 29.9% (2,280/7,623) of them had week-one anaemia (haemoglobin <10 g/dL). We found that anaemia was independently associated with an increased risk of one-year mortality after adjustment for relevant covariates (aHR, 1.170; 95% CI, 1.045-1.310). We further identified a consistent strength of association between anaemia and one-year mortality in propensity score-based analyses, with the adjusted HRs in the PSM, IPTW, and CBPS were 1.164 (95% CI 1.025-1.322), 1.179 (95% CI 1.030-1.348), and 1.181 (1.034-1.349), respectively.
We identified the impact on one-year mortality of anaemia in critically ill surgical patients, and more studies are needed to validate our findings.
贫血对外科患者有不良影响，但危重症外科患者贫血的长期影响尚不清楚。
我们纳入了 2015 年至 2020 年期间在台湾中部一家三级转诊中心的外科重症监护病房（ICU）连续收治的患者。我们使用 Cox 比例风险分析和倾向评分匹配（PSM）、逆概率治疗加权（IPTW）和协变量平衡倾向评分（CBPS）进行分析，以确定血红蛋白<10 g/dL 的一周内贫血（1 年内死亡率的危险比（HR）和 95%置信区间（CI）。
共纳入 7623 例危重症外科患者，其中 29.9%（2280/7623）的患者在第 1 周发生贫血。我们发现，在校正相关协变量后，贫血与 1 年内死亡率的增加独立相关（调整后 HR，1.170；95%CI，1.045-1.310）。我们进一步在倾向评分分析中发现了贫血与 1 年内死亡率之间一致的关联强度，PSM、IPTW 和 CBPS 中的调整后 HR 分别为 1.164（95%CI，1.025-1.322）、1.179（95%CI，1.030-1.348）和 1.181（1.034-1.349）。
我们确定了贫血对危重症外科患者 1 年内死亡率的影响，需要进一步研究来验证我们的发现。
