Zhou Ren, Qian Dewei, Li Haiqing, Wang Zhe, Shi Sheng, Shen Feng, Cheng Lin, Yang Dicheng, Yu Min
Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Cardiovascular Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2022 Nov 22;9:1053209. doi: 10.3389/fcvm.2022.1053209. eCollection 2022.
Intraoperative transfusion is associated with adverse clinical outcomes in cardiac surgery. However, few studies have shown the impact of intraoperative red blood cell (RBC) transfusion on non-anemic patients undergoing cardiac surgery. We assessed the in-hospital clinical outcomes of non-anemic patients undergoing isolated valve replacements and investigated the predictors associated with intraoperative RBC transfusion.
We enrolled 345 non-anemic patients undergoing isolated valve replacements in our department from January 2015 to December 2019. The patients were stratified by the receipt of intraoperative RBC transfusion. Baseline characteristics were compared between groups and multiple logistic regression was used to identify the predictors for intraoperative RBC transfusion. The association between intraoperative RBC transfusion and in-hospital outcomes was also evaluated.
Intraoperative RBC transfusion developed in 84 of the 345 enrolled patients (24.3%). Three independent predictors for intraoperative RBC transfusion of non-anemic patients undergoing isolated valve replacements were identified by multivariate logistic analysis, including female, iron deficiency and hemoglobin level. When the two groups were compared, a significant tendency of higher in-hospital mortality (6.0% vs. 1.1%, = 0.033) and higher incidence of postoperative hypoxemia (9.5% vs. 2.7%, = 0.007) were observed in the intraoperative RBC transfusion group. After adjustment, the presence of intraoperative RBC transfusion was associated with an increase in postoperative hypoxemia (OR = 3.36, 95% CI: 1.16-9.71, = 0.026).
Intraoperative RBC transfusion was associated with poorer clinical outcomes in non-anemic adults undergoing isolated valve replacements, which significantly increased the risk of postoperative hypoxemia. The independent predictors of intraoperative RBC transfusion, such as iron deficiency and female, were identified, which may be helpful for risk assessment and perioperative management.
心脏手术中的术中输血与不良临床结局相关。然而，很少有研究显示术中红细胞（RBC）输血对接受心脏手术的非贫血患者的影响。我们评估了接受单纯瓣膜置换术的非贫血患者的院内临床结局，并调查了与术中RBC输血相关的预测因素。
我们纳入了2015年1月至2019年12月在我院接受单纯瓣膜置换术的345例非贫血患者。患者根据是否接受术中RBC输血进行分层。比较两组的基线特征，并使用多因素logistic回归确定术中RBC输血的预测因素。还评估了术中RBC输血与院内结局之间的关联。
345例纳入患者中有84例（24.3%）发生术中RBC输血。通过多因素logistic分析确定了接受单纯瓣膜置换术的非贫血患者术中RBC输血的三个独立预测因素，包括女性、缺铁和血红蛋白水平。两组比较时，术中RBC输血组的院内死亡率显著更高（6.0%对1.1%，P = 0.033），术后低氧血症发生率也更高（9.5%对2.7%，P = 0.007）。调整后，术中RBC输血与术后低氧血症增加相关（OR = 3.36，95%CI：1.16 - 9.71，P = 0.026）。
术中RBC输血与接受单纯瓣膜置换术的非贫血成人较差的临床结局相关，这显著增加了术后低氧血症的风险。确定了术中RBC输血的独立预测因素，如缺铁和女性，这可能有助于风险评估和围手术期管理。
Zotero 插件
