Does transfusion practice affect mortality in critically ill patients? Transfusion Requirements in Critical Care (TRICC) Investigators and the Canadian Critical Care Trials Group.

  • Hébert P
  • Wells G
  • Tweeddale M
 et al. 
  • 24

    Readers

    Mendeley users who have this article in their library.
  • N/A

    Citations

    Citations of this article.

Abstract

In 4,470 critically ill patients, we examined the impact of transfusion practice on mortality rates. As compared with survivors, patients who died in intensive care units (ICU) had lower hemoglobin values (95 +/- 26 versus 104 +/- 23 g/L, p < 0.0001) and were transfused red cells more frequently (42.6% versus 28.0%, p < 0.0001). In patients with cardiac disease, there was a trend toward an increased mortality when hemoglobin values were < 95 g/L (55% versus 42%, p = 0.09) as compared with anemic patients with other diagnoses. Patients with anemia, a high APACHE II score (> 20), and a cardiac diagnosis had a significantly lower mortality rate when given 1 to 3 or 4 to 6 units of allogeneic red cells (55% [no transfusions] versus 35% [1 to 3 units] or 32% [4 to 6 units], respectively, p = 0.01). Adjusted odds ratio (OR) predicting survival were 0.61 (95% CI; 0.37 to 1.00, p = 0.026) after 1 to 3 units and 0.49 (95% CI; 0.23 to 1.03, p = 0.03) after 4 to 6 units compared with nontransfused anemic patients. In the subgroup with cardiac disease, increasing hemoglobin values in anemic patients was associated with improved survival (OR = 0.80 for each 10 g/L increase, p = 0.012). We conclude that anemia increases the risk of death in critically ill patients with cardiac disease. Blood transfusions appear to decrease this risk.

Author-supplied keywords

  • APACHE
  • Aged
  • Anemia
  • Anemia: blood
  • Anemia: complications
  • Anemia: therapy
  • Blood Transfusion
  • Cardiovascular Diseases
  • Cardiovascular Diseases: complications
  • Cardiovascular Diseases: mortality
  • Cohort Studies
  • Critical Illness
  • Critical Illness: mortality
  • Female
  • Hemoglobins
  • Hemoglobins: analysis
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors
  • Survival Rate

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Authors

  • P C Hébert

  • G Wells

  • M Tweeddale

  • C Martin

  • J Marshall

  • B Pham

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free