Age of red blood cells and mortality in the critically ill

Pettilä, Ville, Westbrook, Andrew J, Nichol, Alistair D, Bailey, Michael J, Wood, Erica M, Syres, Gillian, Phillips, Louise E, Street, Alison, French, Craig, Murray, Lynnette, Orford, Neil, Santamaria, John D, Bellomo, Rinaldo, Cooper, David J and Blood Observational Study Investigators for ANZICS Clinical Trials Group 2011, Age of red blood cells and mortality in the critically ill, Critical care, vol. 15, no. 2, pp. 1-8, doi: 10.1186/cc10142.

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Title Age of red blood cells and mortality in the critically ill
Author(s) Pettilä, Ville
Westbrook, Andrew J
Nichol, Alistair D
Bailey, Michael J
Wood, Erica M
Syres, Gillian
Phillips, Louise E
Street, Alison
French, Craig
Murray, Lynnette
Orford, NeilORCID iD for Orford, Neil
Santamaria, John D
Bellomo, Rinaldo
Cooper, David J
Blood Observational Study Investigators for ANZICS Clinical Trials Group
Journal name Critical care
Volume number 15
Issue number 2
Article ID R116
Start page 1
End page 8
Total pages 8
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2011
ISSN 1466-609X
Keyword(s) hospital mortality
lower quartile
prospective multicenter observational study
increase hospital mortality
pretransfusion hemoglobin
critical illness
erythrocyte aging
erythrocyte transfusion
science & technology
life sciences & biomedicine
critical care medicine
general & internal medicine
Summary 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.
Language eng
DOI 10.1186/cc10142
Field of Research 11 Medical And Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2011, Pettilä et al.
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