Impact of the transfusion of hemate concentrates in critical patients on a polyvalent intensive care unit in argentina

Abstract

OBJECTIVE: to assess whether the erythrocytes transfusion in the critically ill patient in our Intensive Care Unit (ICU) is associated with higher mortality.

DESIGN: A retrospective observational study was made since January 2009 to December 2018.

SETTING: An ICU in a tertiary hospital.

PATIENTS: Patients of 18 years old or older, from both sexes, hospitalized for at least 24 hours.

INTERVENTIONS: None.

VARIABLES OF INTEREST: Number of erythrocytes transfusions and ICU mortality.

RESULTS: Data of 4244 patients, who gathered the required information, were analyzed. The average age was50,35 (±17,14) years, 64,6% were male, the average days of hospitalization in ICU were6,61 (±8,94) days, APACHE II 14,74 (±8,67), SAPS II 36,87 (±19,40), SOFA 4,96 (±3,72), 46,9% required mechanical ventilation and mortality was 24,6%. 735 patients required erythrocytes transfusions (17.3%). When these were compared with those not transfused, it was observed that the former presented younger age (51 vs. 53 years, p <0.001), higher severity scores (APACHE II 17 vs. 13 p <0.001; SAPS II 40 vs. 32 p <0.001; SOFA 6 vs. 4 p <0.001), longer ICU stay (6 vs. 3 days, p <0.001), need of mechanical ventilation (65.7 vs. 42.9%, p <0.001) and mortality (34 vs. 22.6%, <0.001). The multivariate logistic regression analysis showed that the patients with the highest number of erythrocytes transfusion presented higher mortality in the ICU [odds ratio of 1.066 (95% CI: 1.015-1.119; p 0.01)], adjusting for age, days of hospitalization, severity scales and need for VM.

CONCLUSION: From these results we can conclude that erythrocytes transfusion in critically ill patients was associated with higher mortality in our ICU.