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Anemia prevalence and incidence and red blood cell transfusion practices in aneurysmal subarachnoid hemorrhage: results of a multicenter cohort study
- Source :
- Critical Care, Critical Care, Vol 22, Iss 1, Pp 1-9 (2018)
- Publication Year :
- 2018
-
Abstract
- Background: Whether a restrictive strategy for red blood cell (RBC) transfusion is applied to patients with aneurysmal subarachnoid hemorrhage (aSAH) is unclear. To inform the design and conduct of a future clinical trial, we sought to describe transfusion practices, hemoglobin (Hb) triggers, and predictors of RBC transfusion in patients with aSAH. Methods: This is a retrospective cohort study of all consecutively admitted adult patients with aSAH at four tertiary care centers from January 1, 2012, to December 31, 2013. Patients were identified from hospital administrative discharge records and existing local aSAH databases. Data collection by trained abstractors included demographic data, aSAH characteristics, Hb and transfusion data, other major aSAH cointerventions, and outcomes using a pretested case report form with standardized procedures. Descriptive statistics were used to summarize data, and regression models were used to identify associations between anemia, transfusion, and other relevant predictors and outcome. Results: A total of 527 patients met inclusion eligibility. Mean (±SD) age was 57 ± 13 years, and 357 patients (67.7%) were female. The median modified Fisher grade was 4 (IQR 3–4). Mean nadir Hb was 98 ± 20 g/L and occurred on median admission day 4 (IQR 2–11). RBC transfusion occurred in 100 patients (19.0%). Transfusion rates varied across centers (12.1–27.4%, p = 0.02). Patients received a median of 1 RBC unit (IQR 1–2) per transfusion episode and a median total of 2 units (IQR 1–4). Median pretransfusion Hb for first transfusion was 79 g/L (IQR 74–93) and did not vary substantially across centers (78–82 g/L, p = 0.37). Of patients with nadir Hb
- Subjects :
- Adult
Male
Canada
medicine.medical_specialty
Subarachnoid hemorrhage
Anemia
Red blood cell transfusion
Critical Care and Intensive Care Medicine
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Prevalence
Humans
Medicine
Case report form
Cerebral aneurysm
Retrospective Studies
business.industry
Research
Incidence
Incidence (epidemiology)
Confounding
lcsh:Medical emergencies. Critical care. Intensive care. First aid
030208 emergency & critical care medicine
Retrospective cohort study
lcsh:RC86-88.9
Middle Aged
Subarachnoid Hemorrhage
medicine.disease
Clinical trial
Female
Cohort study
Erythrocyte Transfusion
business
030217 neurology & neurosurgery
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Critical Care, Critical Care, Vol 22, Iss 1, Pp 1-9 (2018)
- Accession number :
- edsair.doi.dedup.....1f0a4f91f83f4c69cf38bd1f04cabc8f