PDF(Pubmed)
Abstract：
UNASSIGNED: To evaluate the effect of autologous blood use on blood product consumption and outcomes after acute type A aortic dissection repair.
UNASSIGNED: From 2010 to October 2020, 497 patients underwent open acute type A aortic dissection repair, including those with autologous blood harvesting before cardiopulmonary bypass and transfusion after cardiopulmonary bypass (autologous blood transfusion [ABT], n = 397) and without autologous blood harvesting and transfusion (No-ABT, n = 100). The median ABT volume was 900 mL. Using propensity score matching, 89 matched pairs were identified based on age, sex, body mass index, preoperative hemoglobin, acute preoperative stroke, previous cardiac surgery, and cardiogenic shock.
UNASSIGNED: After propensity score matching, both groups were similar in demographic characteristics and aortic procedures. The ABT group required significantly less intraoperative transfusion of blood products (6 vs 11 units; P < .0001), including packed red blood cells (2 vs 4), fresh frozen plasma (2 vs 4), platelets (2 vs 2), and cryoprecipitate (0 vs 1); and combined intraoperative and postoperative transfusion (9 vs 13; P < .001). ABT was protective against intra- and postoperative blood product transfusion (odds ratio, 0.28; P = .01). The ABT group had significantly less sepsis, acute renal failure requiring dialysis, reintubation, and shorter intubation times and postoperative lengths of stay. Operative mortality was 6.7% in the ABT group versus 13% in the No-ABT group (P = .14). The midterm survival was similar between the 2 groups (5 year: 76% vs 74%). ABT had a hazard ratio of 0.81 for midterm mortality (P = .41).
UNASSIGNED: Autologous blood transfusion was associated with better short-term outcomes and could be used routinely for acute type A aortic dissection repair. External multicenter prospective validation would be warranted.
UNASSIGNED: From 2010 to October 2020, 497 patients underwent open acute type A aortic dissection repair, including those with autologous blood harvesting before cardiopulmonary bypass and transfusion after cardiopulmonary bypass (autologous blood transfusion [ABT], n = 397) and without autologous blood harvesting and transfusion (No-ABT, n = 100). The median ABT volume was 900 mL. Using propensity score matching, 89 matched pairs were identified based on age, sex, body mass index, preoperative hemoglobin, acute preoperative stroke, previous cardiac surgery, and cardiogenic shock.
UNASSIGNED: After propensity score matching, both groups were similar in demographic characteristics and aortic procedures. The ABT group required significantly less intraoperative transfusion of blood products (6 vs 11 units; P < .0001), including packed red blood cells (2 vs 4), fresh frozen plasma (2 vs 4), platelets (2 vs 2), and cryoprecipitate (0 vs 1); and combined intraoperative and postoperative transfusion (9 vs 13; P < .001). ABT was protective against intra- and postoperative blood product transfusion (odds ratio, 0.28; P = .01). The ABT group had significantly less sepsis, acute renal failure requiring dialysis, reintubation, and shorter intubation times and postoperative lengths of stay. Operative mortality was 6.7% in the ABT group versus 13% in the No-ABT group (P = .14). The midterm survival was similar between the 2 groups (5 year: 76% vs 74%). ABT had a hazard ratio of 0.81 for midterm mortality (P = .41).
UNASSIGNED: Autologous blood transfusion was associated with better short-term outcomes and could be used routinely for acute type A aortic dissection repair. External multicenter prospective validation would be warranted.
摘要：
未经授权：评估自体血液使用对急性A型主动脉夹层修复后血液制品消耗和结局的影响。
UNASSIGNED：从2010年到2020年10月，497例患者接受了开放性急性A型主动脉夹层修复术，包括体外循环前自体采血和体外循环后输血的患者（自体输血[ABT]，n=397)，不进行自体血液采集和输血(无ABT，n=100)。中位ABT体积为900mL。使用倾向得分匹配，根据年龄确定了89对匹配的对，性别,身体质量指数,术前血红蛋白,急性术前中风，以前做过心脏手术,和心源性休克.
未经评估：倾向评分匹配后，两组在人口统计学特征和主动脉手术方面相似.ABT组术中输血量明显减少（6vs11单位；P<0.0001），包括红细胞（2比4），新鲜冷冻血浆（2vs4），血小板（2vs2），冷沉淀（0vs1）；术中和术后联合输血（9vs13；P<.001）。ABT可防止术中和术后输血（比值比，0.28；P=0.01）。ABT组脓毒症明显减少,需要透析的急性肾衰竭，再插管,插管时间和术后住院时间较短。ABT组手术死亡率为6.7%，非ABT组为13%(P=0.14)。两组的中期生存率相似（5年：76％vs74％）。ABT的中期死亡率风险比为0.81（P=0.41）。
UASSIGNED：自体输血与较好的短期预后相关，可常规用于急性A型主动脉夹层修复。需要进行外部多中心前瞻性验证。
UNASSIGNED：从2010年到2020年10月，497例患者接受了开放性急性A型主动脉夹层修复术，包括体外循环前自体采血和体外循环后输血的患者（自体输血[ABT]，n=397)，不进行自体血液采集和输血(无ABT，n=100)。中位ABT体积为900mL。使用倾向得分匹配，根据年龄确定了89对匹配的对，性别,身体质量指数,术前血红蛋白,急性术前中风，以前做过心脏手术,和心源性休克.
未经评估：倾向评分匹配后，两组在人口统计学特征和主动脉手术方面相似.ABT组术中输血量明显减少（6vs11单位；P<0.0001），包括红细胞（2比4），新鲜冷冻血浆（2vs4），血小板（2vs2），冷沉淀（0vs1）；术中和术后联合输血（9vs13；P<.001）。ABT可防止术中和术后输血（比值比，0.28；P=0.01）。ABT组脓毒症明显减少,需要透析的急性肾衰竭，再插管,插管时间和术后住院时间较短。ABT组手术死亡率为6.7%，非ABT组为13%(P=0.14)。两组的中期生存率相似（5年：76％vs74％）。ABT的中期死亡率风险比为0.81（P=0.41）。
UASSIGNED：自体输血与较好的短期预后相关，可常规用于急性A型主动脉夹层修复。需要进行外部多中心前瞻性验证。
