Anemia and Transfusions in Critically Ill Patients on Mechanical Ventilation
Author Information
Author(s): Marya D Zilberberg, Lee S Stern, Daniel P Wiederkehr, John J Doyle, Andrew F Shorr
Primary Institution: School of Public Health and Health Sciences, University of Massachusetts
Hypothesis
Transfusions among patients receiving prolonged acute mechanical ventilation (PAMV) are common and associated with worsened clinical and economic outcomes.
Conclusion
Transfusions independently contribute to increased risk for hospital death, length of stay, and costs in patients receiving PAMV.
Supporting Evidence
- 67% of patients receiving PAMV received at least one transfusion.
- Transfusions were associated with a 21% increase in the risk of hospital death.
- Transfused patients had a longer hospital stay by an average of 6.3 days.
- The average cost increase associated with transfusions was $48,972.
Takeaway
Many patients on long-term breathing machines get blood transfusions even when their blood levels are okay, which can make them sicker and cost more money.
Methodology
A retrospective analysis of a large integrated claims database covering a 5-year period was conducted in adult patients receiving PAMV.
Potential Biases
Potential for residual confounding and inaccuracies in identifying hospital complications due to reliance on administrative coding.
Limitations
The study's retrospective nature may introduce selection bias, and it was conducted in a single health care system, limiting generalizability.
Participant Demographics
The cohort included 4,344 hospitalized patients, 55% male, mean age 61.5 years, with a significant proportion being African-American.
Statistical Information
P-Value
0.0014
Confidence Interval
95% CI = 1.00 to 1.48
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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