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Multicenter Study
. 2022 Oct 7;26(1):307.
doi: 10.1186/s13054-022-04171-1.

Association between in-ICU red blood cells transfusion and 1-year mortality in ICU survivors

Alice Blet #  1 , Joel B McNeil #  2 , Julie Josse #  3 , Bernard Cholley  4   5 , Raphaël Cinotti  6 , Gad Cotter  7 , Agnès Dauvergne  8 , Beth Davison  7 , Kévin Duarte  9 , Jacques Duranteau  10 , Marie-Céline Fournier  1 , Etienne Gayat  1 , Samir Jaber  11 , Sigismond Lasocki  12 , Thomas Merkling  9 , Katell Peoc'h  13 , Imke Mayer  14 , Malha Sadoune  1 , Pierre-François Laterre  15 , Romain Sonneville  16 , Lorraine Ware #  2 , Alexandre Mebazaa #  17 , Antoine Kimmoun #  18
Affiliations
Multicenter Study

Association between in-ICU red blood cells transfusion and 1-year mortality in ICU survivors

Alice Blet et al. Crit Care. .

Abstract

Background: Impact of in-ICU transfusion on long-term outcomes remains unknown. The purpose of this study was to assess in critical-care survivors the association between in-ICU red blood cells transfusion and 1-year mortality.

Methods: FROG-ICU, a multicenter European study enrolling all-comers critical care patients was analyzed (n = 1551). Association between red blood cells transfusion administered in intensive care unit and 1-year mortality in critical care survivors was analyzed using an augmented inverse probability of treatment weighting-augmented inverse probability of censoring weighting method to control confounders.

Results: Among the 1551 ICU-survivors, 42% received at least one unit of red blood cells while in intensive care unit. Patients in the transfusion group had greater severity scores than those in the no-transfusion group. According to unweighted analysis, 1-year post-critical care mortality was greater in the transfusion group compared to the no-transfusion group (hazard ratio (HR) 1.78, 95% CI 1.45-2.16). Weighted analyses including 40 confounders, showed that transfusion remained associated with a higher risk of long-term mortality (HR 1.21, 95% CI 1.06-1.46).

Conclusions: Our results suggest a high incidence of in-ICU RBC transfusion and that in-ICU transfusion is associated with a higher 1-year mortality among in-ICU survivors. Trial registration ( NCT01367093 ; Registered 6 June 2011).

Keywords: Critical care unit; Mortality; Transfusion.

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Conflict of interest statement

The authors declared that they have no conflict of interest related to the present work.

Figures

Fig. 1
Fig. 1
One-year survival according to transfusion status from discharge in unweighted (A) and weighted (B) populations and from admission in the whole population in unweighted (C) and weighted (D) populations. Weighting has been performed with an AIPTW-AIPCW estimator from the random forest-MIA (non-parametric) imputation. For the whole population sample size from 2087 patients, 72 patients had no or partial follow up and 30 no transfusion data resulting in 1071 patients in the no transfusion group and 914 patients in the transfusion group
Fig. 2
Fig. 2
Averaged effect of transfusion on the restricted survival time for the first 365 days after discharge estimated from non-parametric and parametric methods of missing values management. IPTW: inverse probability of treatment weighting, AIPTW-AIPCW: augmented inverse probability treatment weighting-augmented inverse probability censoring weighting
See this image and copyright information in PMC

Comment in

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