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. 2010 Apr;137(4):783-9.
doi: 10.1378/chest.09-0841. Epub 2009 Oct 16.

Long-term survival and quality of life after transfusion-associated pulmonary edema in critically ill medical patients

Guangxi Li  1 , Marija Kojicic, Martin K Reriani, Evans R Fernández Pérez, Lokendra Thakur, Rahul Kashyap, Camille M Van Buskirk, Ognjen Gajic
Affiliations

Long-term survival and quality of life after transfusion-associated pulmonary edema in critically ill medical patients

Guangxi Li et al. Chest. 2010 Apr.

Abstract

Background: Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) commonly complicate transfusion in critically ill patients. Prior outcome studies of TACO and TRALI have focused on short-term morbidity and mortality, but the long-term survival and quality of life (QOL) of these patients remain unknown.

Methods: In a nested case-control study, we compared survival and QOL between critically ill medical patients who developed pulmonary edema after transfusion (TRALI or TACO) and medical critically ill transfused controls, matched by age, gender, and admission diagnostic group. QOL in survivors was assessed with a 36-item short form health survey 1 year after initial hospitalization.

Results: Hospital, 1-year, and 2-year mortality among the 74 TRALI cases and 74 matched controls were 43.2% vs 24.3% (P = .020), 63.8% vs 46.4% (P = .037) and 74.3% vs 54.3% (P = .031), whereas among the 51 TACO cases and 51 matched controls these values were 7.8% vs 11.8% (P = .727), 38.0% vs 28.0% (P = .371), and 44.9% vs 38.8% (P = .512). When adjusted for age and baseline severity of illness in a Cox proportional hazard analysis, the development of TRALI remained associated with decreased survival (hazard ratio 1.86; 95% CI, 1.19-2.93; P = .006). Both TRALI (P = .006, P = .03) and TACO (P = .03, P = .049) were associated with prolonged ICU and hospital lengths of stay.

Conclusions: In critically ill medical patients, development of TRALI, but not TACO, is independently associated with decreased long-term survival.

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Figures

Figure 1.
Figure 1.
Survival curve of TRALI/possible TRALI vs matched control group (A). Survival curve of TACO vs matched control group (B). TACO = transfusion-associated circulatory overload; TRALI = transfusion-associated acute lung injury.
Figure 2.
Figure 2.
Survival curve of no TRALI, TRALI, and possible TRALI. See Figure 1 legend for expansion of abbreviation.
Figure 3.
Figure 3.
Mean SF-36 scores 1 year later. TRALI vs matched controls (A). TACO vs matched controls (B). SF-36 = 36-item short form health survey. See Figure 1 legend for expansion of other abbreviations.
See this image and copyright information in PMC

References

    1. US Food and Drug Administration Fatalities reported to FDA following blood collection and transfusion: annual summary for fiscal year 2007. http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ReportaProb....
    1. Gajic O, Rana R, Winters JL, et al. Transfusion-related acute lung injury in the critically ill: prospective nested case-control study. Am J Respir Crit Care Med. 2007;176(9):886–891. - PMC - PubMed
    1. Popovsky MA, Chaplin HC, Jr, Moore SB. Transfusion-related acute lung injury: a neglected, serious complication of hemotherapy. Transfusion. 1992;32(6):589–592. - PubMed
    1. Kopko PM, Marshall CS, MacKenzie MR, Holland PV, Popovsky MA. Transfusion-related acute lung injury: report of a clinical look-back investigation. JAMA. 2002;287(15):1968–1971. - PubMed
    1. Popovsky MA. Transfusion and the lung: circulatory overload and acute lung injury. Vox Sang. 2004;87(suppl 2):62–65. - PubMed

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