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Observational Study
. 2022 Apr;164(4):985-999.
doi: 10.1007/s00701-022-05144-7. Epub 2022 Feb 26.

Preoperative anaemia and red blood cell transfusion in patients with aneurysmal subarachnoid and intracerebral haemorrhage - a multicentre subanalysis of the German PBM Network Registry

Elke Schmitt  1   2 , Patrick Meybohm  3   4 , Vanessa Neef  1 , Peter Baumgarten  5   6 , Alexandra Bayer  7 , Suma Choorapoikayil  1 , Patrick Friederich  8 , Jens Friedrich  9 , Christof Geisen  10 , Erdem Güresir  11 , Matthias Grünewald  12 , Martin Gutjahr  13 , Philipp Helmer  14 , Eva Herrmann  2 , Markus Müller  10 , Diana Narita  15 , Ansgar Raadts  16 , Klaus Schwendner  17 , Erhard Seifried  10 , Patrick Stark  18 , Andrea U Steinbicker  1   19 , Josef Thoma  20 , Markus Velten  21 , Henry Weigt  22 , Christoph Wiesenack  23 , Maria Wittmann  21 , Kai Zacharowski  24 , Florian Piekarski  1 ; German PBM Network Collaborators
Affiliations
Observational Study

Preoperative anaemia and red blood cell transfusion in patients with aneurysmal subarachnoid and intracerebral haemorrhage - a multicentre subanalysis of the German PBM Network Registry

Elke Schmitt et al. Acta Neurochir (Wien). 2022 Apr.

Abstract

Purpose: Anaemia is common in patients presenting with aneurysmal subarachnoid (aSAH) and intracerebral haemorrhage (ICH). In surgical patients, anaemia was identified as an idenpendent risk factor for postoperative mortality, prolonged hospital length of stay (LOS) and increased risk of red blood cell (RBC) transfusion. This multicentre cohort observation study describes the incidence and effects of preoperative anaemia in this critical patient collective for a 10-year period.

Methods: This multicentre observational study included adult in-hospital surgical patients diagnosed with aSAH or ICH of 21 German hospitals (discharged from 1 January 2010 to 30 September 2020). Descriptive, univariate and multivariate analyses were performed to investigate the incidence and association of preoperative anaemia with RBC transfusion, in-hospital mortality and postoperative complications in patients with aSAH and ICH.

Results: A total of n = 9081 patients were analysed (aSAH n = 5008; ICH n = 4073). Preoperative anaemia was present at 28.3% in aSAH and 40.9% in ICH. RBC transfusion rates were 29.9% in aSAH and 29.3% in ICH. Multivariate analysis revealed that preoperative anaemia is associated with a higher risk for RBC transfusion (OR = 3.25 in aSAH, OR = 4.16 in ICH, p < 0.001), for in-hospital mortality (OR = 1.48 in aSAH, OR = 1.53 in ICH, p < 0.001) and for several postoperative complications.

Conclusions: Preoperative anaemia is associated with increased RBC transfusion rates, in-hospital mortality and postoperative complications in patients with aSAH and ICH.

Trial registration: ClinicalTrials.gov , NCT02147795, https://clinicaltrials.gov/ct2/show/NCT02147795.

Keywords: Anaemia; Aneurysmal subarachnoid haemorrhage; Intracerebral haemorrhage; Patient blood management; Red blood cell transfusion.

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Conflict of interest statement

PM received honoraria for scientific lectures from Belgian Red Cross, Biotest, CSL Behring GmbH, Bundesamt für Bevölkerungsschutz und Katastrophenhilfe (BKK), Fresenius, Haemonetics, Landesärztekammer Sachsen, Landesärztekammer Hessen, Masimo, Radiometer, Schöchl medical Education, Thieme-Verlag, Trillium Diagnostik, Werfen GmbH, ViforPharma GmbH. PB received travel grants from Roche and Medac. KZ and his department received support from B. Braun Melsungen, CSL Behring, Fresenius Kabi, and Vifor Pharma for the implementation of Frankfurt‘s Patient Blood Management program and received honoraria for scientific lectures from CSL Behring, implatcast GmbH, med Update GmbH, Pharmacosmos and Vifor Pharma. MG received honoraria for scientific lectures from CSL Behring and Vifor Pharma. FP received honoraria from Pharmacosmos for scientific lectures.

Figures

Fig. 1
Fig. 1
The inclusion and exclusion criteria among patients analysed
Fig. 2
Fig. 2
The mortality rate dependent on the preoperative Hb values for a Aneurysmal subarachnoid haemorrhage (aSAH) and b Intracerebral haemorrhage (ICH). Ninety-five percent confidence intervals (error bars) are shown
Fig. 3
Fig. 3
The RBC transfusion rate dependent on the preoperative Hb values for a Aneurysmal subarachnoid haemorrhage (aSAH) and b Intracerebral haemorrhage (ICH). Ninety-five percent confidence intervals (error bars) are shown
See this image and copyright information in PMC

References

    1. Althoff FC, Neb H, Herrmann E, Trentino KM, Vernich L, Fullenbach C, Freedman J, Waters JH, Farmer S, Leahy MF, Zacharowski K, Meybohm P, Choorapoikayil S. Multimodal patient blood management program based on a three-pillar strategy: a systematic review and meta-analysis. Ann Surg. 2019;269:794–804. doi: 10.1097/SLA.0000000000003095. - DOI - PubMed
    1. Baron DM, Hochrieser H, Posch M, Metnitz B, Rhodes A, Moreno RP, Pearse RM, Metnitz P, European Surgical Outcomes Study group for Trials Groups of European Society of Intensive Care M, European Society of A Preoperative anaemia is associated with poor clinical outcome in non-cardiac surgery patients. Br J Anaesth. 2014;113:416–423. doi: 10.1093/bja/aeu098. - DOI - PubMed
    1. Ceanga AI, Ceanga M, Eveslage M, Herrmann E, Fischer D, Haferkamp A, Wittmann M, Muller S, Van Aken H, Steinbicker AU. Preoperative anemia and extensive transfusion during stay-in-hospital are critical for patient`s mortality: a retrospective multicenter cohort study of oncological patients undergoing radical cystectomy. Transfus Apher Sci. 2018;57:739–745. doi: 10.1016/j.transci.2018.08.003. - DOI - PubMed
    1. Cohen JA, Alan N, Seicean A, Weil RJ. Risk associated with perioperative red blood cell transfusion in cranial surgery. Neurosurg Rev. 2017;40:633–642. doi: 10.1007/s10143-017-0819-y. - DOI - PubMed
    1. Dhar R, Zazulia AR, Derdeyn CP, Diringer MN. RBC Transfusion improves cerebral oxygen delivery in subarachnoid hemorrhage. Crit Care Med. 2017;45:653–659. doi: 10.1097/CCM.0000000000002266. - DOI - PMC - PubMed

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