Long length of stay in the ICU associates with a high erythrocyte transfusion rate in critically ill patients

OBJECTIVE: This study aimed to evaluate epidemiology and outcome among critically ill patients under a restrictive transfusion practice. METHODS: One hundred sixty-nine patients who were admitted to the intensive care unit (ICU) between March 2016 to December 2017 and remained in the ICU > 24 hours were retrospectively included. RESULTS: Hemoglobin levels on admission were <12 g/dL in 85% and <9 g/dL in 37.9% of patients. The median admission hemoglobin level was decreased on the last day of the ICU stay. Erythrocyte transfusion was required for 34% of patients. Transfused patients had high Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores, more requirement for invasive mechanical ventilation, vasopressors, and dialysis, long ICU and hospital stays, low hemoglobin levels, and high hospital and ICU mortality rates. Multivariate analysis showed that the likelihood of transfusion increased from 6.6 to 25.8 fold when the ICU stay extended from ≥7 to ≥15 days. Age, vasopressor use, dialysis, and erythrocyte transfusion ≥5 units were predictors of mortality. CONCLUSION: Patients receiving transfusion are severely ill and have more life support therapies. The number of erythrocyte units transfused, age, and organ support therapies are independent predictors of mortality.