Age of red blood cells and mortality in the critically ill

Hdl Handle:
http://hdl.handle.net/10147/134175
Title:
Age of red blood cells and mortality in the critically ill
Authors:
Pettila, Ville; Westbrook, Andrew J; Nichol, Alistair D; Bailey, Michael J; Wood, Erica M; Syres, Gillian; Phillips, Louise E; Street, Alison; French, Craig; Murray, Lynette; Orford, Neil; Santamaria, John D; Bellomo, Rinaldo; Cooper, David J; Blood Observational Study Investigators, The; ANZICS-Clinical Trials Group, The
Citation:
Critical Care. 2011 Apr 15;15(2):R116
Issue Date:
15-Apr-2011
URI:
http://hdl.handle.net/10147/134175
Abstract:
Abstract Introduction In critically ill patients, it is uncertain whether exposure to older red blood cells (RBCs) may contribute to mortality. We therefore aimed to evaluate the association between the age of RBCs and outcome in a large unselected cohort of critically ill patients in Australia and New Zealand. We hypothesized that exposure to even a single unit of older RBCs may be associated with an increased risk of death. Methods We conducted a prospective, multicenter observational study in 47 ICUs during a 5-week period between August 2008 and September 2008. We included 757 critically ill adult patients receiving at least one unit of RBCs. To test our hypothesis we compared hospital mortality according to quartiles of exposure to maximum age of RBCs without and with adjustment for possible confounding factors. Results Compared with other quartiles (mean maximum red cell age 22.7 days; mortality 121/568 (21.3%)), patients treated with exposure to the lowest quartile of oldest RBCs (mean maximum red cell age 7.7 days; hospital mortality 25/189 (13.2%)) had an unadjusted absolute risk reduction in hospital mortality of 8.1% (95% confidence interval = 2.2 to 14.0%). After adjustment for Acute Physiology and Chronic Health Evaluation III score, other blood component transfusions, number of RBC transfusions, pretransfusion hemoglobin concentration, and cardiac surgery, the odds ratio for hospital mortality for patients exposed to the older three quartiles compared with the lowest quartile was 2.01 (95% confidence interval = 1.07 to 3.77). Conclusions In critically ill patients, in Australia and New Zealand, exposure to older RBCs is independently associated with an increased risk of death.
Item Type:
Journal Article

Full metadata record

DC FieldValue Language
dc.contributor.authorPettila, Ville-
dc.contributor.authorWestbrook, Andrew J-
dc.contributor.authorNichol, Alistair D-
dc.contributor.authorBailey, Michael J-
dc.contributor.authorWood, Erica M-
dc.contributor.authorSyres, Gillian-
dc.contributor.authorPhillips, Louise E-
dc.contributor.authorStreet, Alison-
dc.contributor.authorFrench, Craig-
dc.contributor.authorMurray, Lynette-
dc.contributor.authorOrford, Neil-
dc.contributor.authorSantamaria, John D-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorCooper, David J-
dc.contributor.authorBlood Observational Study Investigators, The-
dc.contributor.authorANZICS-Clinical Trials Group, The-
dc.date.accessioned2011-06-22T11:23:49Z-
dc.date.available2011-06-22T11:23:49Z-
dc.date.issued2011-04-15-
dc.identifierhttp://dx.doi.org/10.1186/cc10142-
dc.identifier.citationCritical Care. 2011 Apr 15;15(2):R116-
dc.identifier.urihttp://hdl.handle.net/10147/134175-
dc.description.abstractAbstract Introduction In critically ill patients, it is uncertain whether exposure to older red blood cells (RBCs) may contribute to mortality. We therefore aimed to evaluate the association between the age of RBCs and outcome in a large unselected cohort of critically ill patients in Australia and New Zealand. We hypothesized that exposure to even a single unit of older RBCs may be associated with an increased risk of death. Methods We conducted a prospective, multicenter observational study in 47 ICUs during a 5-week period between August 2008 and September 2008. We included 757 critically ill adult patients receiving at least one unit of RBCs. To test our hypothesis we compared hospital mortality according to quartiles of exposure to maximum age of RBCs without and with adjustment for possible confounding factors. Results Compared with other quartiles (mean maximum red cell age 22.7 days; mortality 121/568 (21.3%)), patients treated with exposure to the lowest quartile of oldest RBCs (mean maximum red cell age 7.7 days; hospital mortality 25/189 (13.2%)) had an unadjusted absolute risk reduction in hospital mortality of 8.1% (95% confidence interval = 2.2 to 14.0%). After adjustment for Acute Physiology and Chronic Health Evaluation III score, other blood component transfusions, number of RBC transfusions, pretransfusion hemoglobin concentration, and cardiac surgery, the odds ratio for hospital mortality for patients exposed to the older three quartiles compared with the lowest quartile was 2.01 (95% confidence interval = 1.07 to 3.77). Conclusions In critically ill patients, in Australia and New Zealand, exposure to older RBCs is independently associated with an increased risk of death.-
dc.titleAge of red blood cells and mortality in the critically ill-
dc.typeJournal Article-
dc.language.rfc3066en-
dc.rights.holderPettila et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2011-06-21T16:03:36Z-
All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.