Cargando…
Lower hemoglobin transfusion trigger is associated with higher mortality in patients hospitalized with pneumonia
Patients hospitalized with pneumonia may require packed red blood cell (RBC) transfusion during their hospital stay. Patient survival may be associated with the transfusion trigger. These patients may need a higher hemoglobin (Hb) trigger than that suggested by the AABB guidelines (7 g/dL). The obje...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895359/ https://www.ncbi.nlm.nih.gov/pubmed/29561440 http://dx.doi.org/10.1097/MD.0000000000010192 |
_version_ | 1783313644051759104 |
---|---|
author | Rahimi-Levene, Naomi Koren-Michowitz, Maya Zeidenstein, Ronit Peer, Victoria Golik, Ahuva Ziv-Baran, Tomer |
author_facet | Rahimi-Levene, Naomi Koren-Michowitz, Maya Zeidenstein, Ronit Peer, Victoria Golik, Ahuva Ziv-Baran, Tomer |
author_sort | Rahimi-Levene, Naomi |
collection | PubMed |
description | Patients hospitalized with pneumonia may require packed red blood cell (RBC) transfusion during their hospital stay. Patient survival may be associated with the transfusion trigger. These patients may need a higher hemoglobin (Hb) trigger than that suggested by the AABB guidelines (7 g/dL). The objective of this study was to evaluate the association between the initial transfusion Hb trigger and in-hospital mortality. A historical cohort study of all patients hospitalized in an internal medicine ward between 2009 and 2014 with pneumonia, who received at least 1 unit of RBC, was evaluated. The primary outcome was all-cause in-hospital mortality. One hundred males and 77 females with a median age of 80 (interquartile range 71–87) years were included. The median Hb trigger was 8.10 g/dL. Mortality rate was 56% in patients with Hb trigger ≤7 g/dL, 43.8% in Hb trigger 7 to 8 g/dL, and 29.5% in Hb trigger >8 g/dL (P = .045). Patients in the 3 Hb trigger categories did not differ in age, sex, comorbidities, albumin, creatinine, C-reactive protein, white blood cells, and platelet counts. The result of a multivariate analysis showed that only lower Hb trigger (odds ratio [OR](≤ 7vs.>8) = 5.24, OR(7–8vs.>8) = 2.13, P = .035) and higher neutrophil count (P = .012) were associated with increased in-hospital mortality. In conclusion, a lower transfusion trigger is associated with increased risk for in-hospital mortality in patients hospitalized with pneumonia requiring RBC transfusion. |
format | Online Article Text |
id | pubmed-5895359 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-58953592018-04-18 Lower hemoglobin transfusion trigger is associated with higher mortality in patients hospitalized with pneumonia Rahimi-Levene, Naomi Koren-Michowitz, Maya Zeidenstein, Ronit Peer, Victoria Golik, Ahuva Ziv-Baran, Tomer Medicine (Baltimore) 4800 Patients hospitalized with pneumonia may require packed red blood cell (RBC) transfusion during their hospital stay. Patient survival may be associated with the transfusion trigger. These patients may need a higher hemoglobin (Hb) trigger than that suggested by the AABB guidelines (7 g/dL). The objective of this study was to evaluate the association between the initial transfusion Hb trigger and in-hospital mortality. A historical cohort study of all patients hospitalized in an internal medicine ward between 2009 and 2014 with pneumonia, who received at least 1 unit of RBC, was evaluated. The primary outcome was all-cause in-hospital mortality. One hundred males and 77 females with a median age of 80 (interquartile range 71–87) years were included. The median Hb trigger was 8.10 g/dL. Mortality rate was 56% in patients with Hb trigger ≤7 g/dL, 43.8% in Hb trigger 7 to 8 g/dL, and 29.5% in Hb trigger >8 g/dL (P = .045). Patients in the 3 Hb trigger categories did not differ in age, sex, comorbidities, albumin, creatinine, C-reactive protein, white blood cells, and platelet counts. The result of a multivariate analysis showed that only lower Hb trigger (odds ratio [OR](≤ 7vs.>8) = 5.24, OR(7–8vs.>8) = 2.13, P = .035) and higher neutrophil count (P = .012) were associated with increased in-hospital mortality. In conclusion, a lower transfusion trigger is associated with increased risk for in-hospital mortality in patients hospitalized with pneumonia requiring RBC transfusion. Wolters Kluwer Health 2018-03-23 /pmc/articles/PMC5895359/ /pubmed/29561440 http://dx.doi.org/10.1097/MD.0000000000010192 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | 4800 Rahimi-Levene, Naomi Koren-Michowitz, Maya Zeidenstein, Ronit Peer, Victoria Golik, Ahuva Ziv-Baran, Tomer Lower hemoglobin transfusion trigger is associated with higher mortality in patients hospitalized with pneumonia |
title | Lower hemoglobin transfusion trigger is associated with higher mortality in patients hospitalized with pneumonia |
title_full | Lower hemoglobin transfusion trigger is associated with higher mortality in patients hospitalized with pneumonia |
title_fullStr | Lower hemoglobin transfusion trigger is associated with higher mortality in patients hospitalized with pneumonia |
title_full_unstemmed | Lower hemoglobin transfusion trigger is associated with higher mortality in patients hospitalized with pneumonia |
title_short | Lower hemoglobin transfusion trigger is associated with higher mortality in patients hospitalized with pneumonia |
title_sort | lower hemoglobin transfusion trigger is associated with higher mortality in patients hospitalized with pneumonia |
topic | 4800 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895359/ https://www.ncbi.nlm.nih.gov/pubmed/29561440 http://dx.doi.org/10.1097/MD.0000000000010192 |
work_keys_str_mv | AT rahimilevenenaomi lowerhemoglobintransfusiontriggerisassociatedwithhighermortalityinpatientshospitalizedwithpneumonia AT korenmichowitzmaya lowerhemoglobintransfusiontriggerisassociatedwithhighermortalityinpatientshospitalizedwithpneumonia AT zeidensteinronit lowerhemoglobintransfusiontriggerisassociatedwithhighermortalityinpatientshospitalizedwithpneumonia AT peervictoria lowerhemoglobintransfusiontriggerisassociatedwithhighermortalityinpatientshospitalizedwithpneumonia AT golikahuva lowerhemoglobintransfusiontriggerisassociatedwithhighermortalityinpatientshospitalizedwithpneumonia AT zivbarantomer lowerhemoglobintransfusiontriggerisassociatedwithhighermortalityinpatientshospitalizedwithpneumonia |