Red blood cell transfusions are associated with lower mortality in patients with severe sepsis and septic shock: A propensity-matched analysis

Dae Won Park, Byung-Chul Chun, Soon Sun Kwon, Young Kyung Yoon, Wonseok Choi, Jang Wook Sohn, Kyong Ran Peck, Yang Soo Kim, Young Hwa Choi, Jun Yong Choi, Sang Il Kim, Joong Sik Eom, Hyo Youl Kim, Hee-Jin Cheong, Young Goo Song, Hee Jung Choi, June Myung Kim, Ja Kim Min

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

ObjectiveS:: To evaluate the effects of transfusions in patients with severe sepsis and septic shock on mortality. DESIGN:: Propensity-matched analysis of a prospective observational database (April 2005 to February 2009). SETTING:: Twenty-two medical and surgical intensive care units in 12 teaching hospitals in Korea. PATIENTS:: One thousand fifty-four patients with community-acquired severe sepsis and septic shock. INTERVENTIONS: None. MEASUREMENTS AND MAIN Results:: Of the 1,054 patients, 407 (38.6%) received a blood transfusion. The mean pretransfusion hemoglobin level was 7.7 ± 1.2 g/dL. Transfused patients had higher 28-day and in-hospital mortality rates (32.7% vs. 17.3%; p < .001, 41.3% vs. 20.3%; p < .001, respectively) and a longer duration of hospital stay (21 [interquartile range, 10-35] vs. 13 [interquartile range, 8-24] days; p < .001), but were more severely ill at admission (lower systolic blood pressure, higher Acute Physiology and Chronic Health Evaluation II score, and Sequential Organ Failure Assessment score at admission). In 152 pairs matched according to the propensity score depending on patient transfusion status, transfused patients had a lower risk of 7-day (9.2% vs. 27.0%; p < .001), 28-day (24.3% vs. 38.8%; p = .007), and in-hospital mortality rates (31.6% vs. 42.8%; p = .044). After adjusting for blood transfusion as a time-dependent variable in multivariable analysis, blood transfusion was independently associated with lower risk of 7-day (hazard ratio 0.42, 95% confidence interval 0.19-0.50, p = .026), 28-day (hazard ratio 0.43, 95% confidence interval 0.29-0.62, p < .001), and in-hospital mortality (hazard ratio 0.51, 95% confidence interval 0.39-0.69, p < .001). Conclusions:: In this observational study of patients with community-acquired severe sepsis and septic shock, red blood cell transfusions were associated with lower risk of mortality.

Original languageEnglish
Pages (from-to)3140-3145
Number of pages6
JournalCritical Care Medicine
Volume40
Issue number12
DOIs
Publication statusPublished - 2012 Dec 1

Keywords

  • blood transfusion
  • mortality
  • septic shock
  • severe sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Fingerprint Dive into the research topics of 'Red blood cell transfusions are associated with lower mortality in patients with severe sepsis and septic shock: A propensity-matched analysis'. Together they form a unique fingerprint.

  • Cite this