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Age of red blood cells and mortality in the critically ill

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Version 2 2024-06-03, 17:34
Version 1 2018-12-04, 11:26
journal contribution
posted on 2024-06-03, 17:34 authored by Ville Pettilä, Andrew J Westbrook, Alistair D Nichol, Michael J Bailey, Erica M Wood, Gillian Syres, Louise E Phillips, Alison Street, Craig French, Lynnette Murray, Neil OrfordNeil Orford, John D Santamaria, Rinaldo Bellomo, David J Cooper, Blood Observational Study Investigators for ANZICS Clinical Trials Group
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.

History

Journal

Critical care

Volume

15

Article number

R116

Pagination

1-8

Location

London, Eng.

Open access

  • Yes

eISSN

1466-609X

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2011, Pettilä et al.

Issue

2

Publisher

BioMed Central

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