Department of Neurology, Vagelos College of Physicians and Surgeons Columbia University New York NY USA.
Department of Epidemiology, Mailman School of Public Health Columbia University New York NY USA.
J Am Heart Assoc. 2023 Jun 6;12(11):e028816. doi: 10.1161/JAHA.122.028816. Epub 2023 May 26.
Background Anemia is associated with poor intracerebral hemorrhage (ICH) outcomes, yet the relationship of red blood cell (RBC) transfusions to ICH complications and functional outcomes remains unclear. We investigated the impact of RBC transfusion on hospital thromboembolic and infectious complications and outcomes in patients with ICH. Methods and Results Consecutive patients with spontaneous ICH enrolled in a single-center, prospective cohort study from 2009 to 2018 were assessed. Primary analyses assessed relationships of RBC transfusions on incident thromboembolic and infectious complications occurring after the transfusion. Secondary analyses assessed relationships of RBC transfusions with mortality and poor discharge modified Rankin Scale score 4 to 6. Multivariable logistic regression models adjusted for baseline demographics and medical disease severity (Acute Physiology and Chronic Health Evaluation II), and ICH severity (ICH score).Of 587 patients with ICH analyzed, 88 (15%) received at least one RBC transfusion. Patients receiving RBC transfusions had worse medical and ICH severity. Though patients receiving RBC transfusions had more complications at any point during the hospitalization (64.8% versus 35.9%), we found no association between RBC transfusion and incident complications in our regression models (adjusted odds ratio [aOR], 0.71 [95% CI, 0.42-1.20]). After adjusting for disease severity and other relevant covariates, we found no significant association between RBC transfusion and mortality (aOR, 0.87 [95% CI, 0.45-1.66]) or poor discharge modified Rankin Scale score (aOR, 2.45 [95% CI, 0.80-7.61]). Conclusions In our cohort with ICH, RBC transfusions were expectedly given to patients with higher medical and ICH severity. Taking disease severity and timing of transfusions into account, RBC transfusion was not associated with incident hospital complications or poor clinical ICH outcomes.
贫血与不良的脑出血（ICH）结局相关，但红细胞（RBC）输注与 ICH 并发症和功能结局的关系仍不清楚。我们研究了 RBC 输注对 ICH 患者住院期间血栓栓塞和感染并发症及结局的影响。
对 2009 年至 2018 年期间在单中心前瞻性队列研究中纳入的连续自发性 ICH 患者进行评估。主要分析评估 RBC 输注与输血后发生的血栓栓塞和感染并发症之间的关系。次要分析评估 RBC 输注与死亡率和不良出院改良 Rankin 量表评分 4 至 6 之间的关系。多变量逻辑回归模型调整了基线人口统计学和医疗疾病严重程度（急性生理学和慢性健康评估 II）以及 ICH 严重程度（ICH 评分）。在分析的 587 例 ICH 患者中，88 例（15%）至少接受了一次 RBC 输注。接受 RBC 输注的患者具有更差的医疗和 ICH 严重程度。尽管接受 RBC 输注的患者在住院期间任何时间都有更多的并发症（64.8%与 35.9%），但我们在回归模型中未发现 RBC 输注与新发并发症之间存在关联（调整后的优势比[aOR]，0.71[95%CI，0.42-1.20]）。在调整疾病严重程度和其他相关协变量后，我们未发现 RBC 输注与死亡率（aOR，0.87[95%CI，0.45-1.66]）或不良出院改良 Rankin 量表评分（aOR，2.45[95%CI，0.80-7.61]）之间存在显著关联。
在我们的 ICH 队列中，RBC 输注是意料之中的，给予了具有更高医疗和 ICH 严重程度的患者。考虑到疾病严重程度和输血时机，RBC 输注与住院期间新发并发症或不良 ICH 临床结局无关。
