METHODS: A registry-based cohort study was performed on 751,893 patients with isolated CABG between January 1, 2015, to December 31, 2019. Using propensity score-weighted regression analysis, we analyzed the effect of intraoperative PRBC on the incidence of PPCs (hospital-acquired pneumonia [HAP], mechanical ventilation for >24 hours, or reintubation), ICU length of stay, and ICU readmission.
RESULTS: Transfusion of 1, 2, 3, and ≥4 units of PRBCs was associated with increased odds for HAP (odds ratios [ORs], 1.24 [95% CI, 1.21-1.26], 1.28 [95% CI, 1.26-1.32], 1.36 [95% CI, 1.33-1.39], 1.31 [95% CI, 1.28-1.34]), reintubation (ORs, 1.23 [95% CI, 1.21-1.25], 1.38 [95% CI, 1.35-1.40], 1.57 [95% CI, 1.55-1.60], 1.70 [95% CI, 1.67-1.73]), prolonged ventilation (ORs, 1.34 [95% CI, 1.33-1.36], 1.56 [95% CI, 1.53-1.58], 1.97 [95% CI, 1.94-2.00], 2.27 [95% CI, 2.24-2.30]), initial ICU length of stay (mean difference in hours, 6.79 [95% CI, 6.00-7.58], 9.55 [95% CI, 8.71-10.38], 17.26 [95% CI, 16.38-18.15], 22.14 [95% CI, 21.22-23.06]), readmission to ICU (ORs, 1.14 [95% CI, 1.12-1.64], 1.15 [95% CI, 1.12-1.17], 1.15 [95% CI, 1.13-1.18], 1.32 [95% CI, 1.29-1.35]), and additional ICU length of stay (mean difference in hours, 0.55 [95% CI, 0.18-0.92], 0.38 [95% CI, 0.00-0.77], 1.02 [95% CI, 0.61-1.43], 1.83 [95% CI, 1.40-2.26]), respectively.
CONCLUSIONS: Intraoperative PRBC transfusion was associated with increased incidence of PPCs, prolonged ICU stay, and ICU readmissions after isolated CABG surgery.
方法:在2015年1月1日至2019年12月31日期间,对751,893例单独的CABG患者进行了基于注册的队列研究。使用倾向得分加权回归分析,我们分析了术中PRBC对PPC(医院获得性肺炎[HAP],机械通气>24小时或再插管),ICU住院时间,ICU再入院。
结果:输注1、2、3和4单位PRBC与HAP的赔率增加相关[赔率比(ORs)1.24(1.21-1.26),1.28(1.26-1.32),1.36(1.33-1.39),1.31(1.28-1.34)],再插管[ORs1.23(1.21-1.25),1.38(1.35-1.40),1.57(1.55-1.60),1.70(1.67-1.73],长时间通气[ORs1.34(1.33-1.36),1.56(1.53-1.58),1.97(1.94-2.00),2.27(2.24-2.30)],初始ICU住院时间[以小时为单位的平均差,6.79(6.00-7.58),9.55(8.71-10.38),17.26(16.38-18.15),22.14(21.22-23.06)],重新进入ICU[ORs1.14(1.12-1.64),1.15(1.12-1.17),1.15(1.13-1.18),1.32(1.29-1.35],和额外的ICU住院时间[以小时为单位的平均差异,0.55(0.18-0.92),0.38(0.00-0.77),1.02(0.61-1.43),1.83(1.40-2.26)]。
结论:术中PRBC输注与PPC的发生率增加有关,ICU住院时间延长,和单独CABG手术后ICU再入院。