Anemia and Blood Transfusion in Critically Ill Patients
CONTEXT Anemia is a common problem in critically ill patients admitted to intensive care units (ICUs), but the consequences of anemia on morbidity and mortality in the critically ill is poorly defined. OBJECTIVES To prospectively define the incidence of anemia and use of red blood cell (RBC) transfu...
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| creator | Vincent, Jean Louis Baron, Jean-François Reinhart, Konrad Gattinoni, Luciano Thijs, Lambert Webb, Andrew Meier-Hellmann, Andreas Nollet, Guy Peres-Bota, Daliana for the ABC Investigators |
| description | CONTEXT Anemia is a common problem in critically ill patients admitted to intensive
care units (ICUs), but the consequences of anemia on morbidity and mortality
in the critically ill is poorly defined. OBJECTIVES To prospectively define the incidence of anemia and use of red blood
cell (RBC) transfusions in critically ill patients and to explore the potential
benefits and risks associated with transfusion in the ICU. DESIGN Prospective observational study conducted November 1999, with 2 components:
a blood sampling study and an anemia and blood transfusion study. SETTING AND PATIENTS The blood sampling study included 1136 patients from 145 western European
ICUs, and the anemia and blood transfusion study included 3534 patients from
146 western European ICUs. Patients were followed up for 28 days or until
hospital discharge, interinstitutional transfer, or death. MAIN OUTCOME MEASURES Frequency of blood drawing and associated volume of blood drawn, collected
over a 24-hour period; hemoglobin levels, transfusion rate, organ dysfunction
(assessed using the Sequential Organ Failure Assessment score), and mortality,
collected throughout a 2-week period. RESULTS The mean (SD) volume per blood draw was 10.3 (6.6) mL, with an average
total volume of 41.1 (39.7) mL during the 24-hour period. There was a positive
correlation between organ dysfunction and the number of blood draws (r = 0.34; P |
| doi_str_mv | 10.1001/jama.288.12.1499 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_72113498</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>195310</ama_id><sourcerecordid>72113498</sourcerecordid><originalsourceid>FETCH-LOGICAL-a395t-215dbe9a8791ac748594830c87d33486c21673ff519efbce19b370c1b17078d33</originalsourceid><addsrcrecordid>eNpd0c1LwzAUAPAgipvTu16kCHprzetLluQ4hx-DgR7muaRtChlpqk172H9vZJOB7_IO78fjfRByDTQDSuFxq1ud5VJmkGfAlDohU-AoU-RKnpIppUqmgkk2IRchbGkMQHFOJpDnDOcopkQsvGmtTrSvkyfXdXWy6bUPzRhs5xPrk2VvB1tp53bJyrnkQw_W-CFckrNGu2CuDnlGPl-eN8u3dP3-ulou1qlGxYc0B16XRmkpFOgqjsIVk0grKWpEJudVDnOBTcNBmaasDKgSBa2gBEGFjGZGHvZ9v_ruezRhKFobKuOc9qYbQyFyAGRKRnj3D267sfdxtuKXcAZx4Rm5PaCxbE1dfPW21f2u-LtHBPcHoENcuom3qGw4OlTIkNPobvYuPuBYVRyB4g9fxHSZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211354136</pqid></control><display><type>article</type><title>Anemia and Blood Transfusion in Critically Ill Patients</title><source>MEDLINE</source><source>American Medical Association Journals</source><creator>Vincent, Jean Louis ; Baron, Jean-François ; Reinhart, Konrad ; Gattinoni, Luciano ; Thijs, Lambert ; Webb, Andrew ; Meier-Hellmann, Andreas ; Nollet, Guy ; Peres-Bota, Daliana ; for the ABC Investigators</creator><creatorcontrib>Vincent, Jean Louis ; Baron, Jean-François ; Reinhart, Konrad ; Gattinoni, Luciano ; Thijs, Lambert ; Webb, Andrew ; Meier-Hellmann, Andreas ; Nollet, Guy ; Peres-Bota, Daliana ; for the ABC Investigators ; ABC (Anemia and Blood Transfusion in Critical Care) Investigators</creatorcontrib><description>CONTEXT Anemia is a common problem in critically ill patients admitted to intensive
care units (ICUs), but the consequences of anemia on morbidity and mortality
in the critically ill is poorly defined. OBJECTIVES To prospectively define the incidence of anemia and use of red blood
cell (RBC) transfusions in critically ill patients and to explore the potential
benefits and risks associated with transfusion in the ICU. DESIGN Prospective observational study conducted November 1999, with 2 components:
a blood sampling study and an anemia and blood transfusion study. SETTING AND PATIENTS The blood sampling study included 1136 patients from 145 western European
ICUs, and the anemia and blood transfusion study included 3534 patients from
146 western European ICUs. Patients were followed up for 28 days or until
hospital discharge, interinstitutional transfer, or death. MAIN OUTCOME MEASURES Frequency of blood drawing and associated volume of blood drawn, collected
over a 24-hour period; hemoglobin levels, transfusion rate, organ dysfunction
(assessed using the Sequential Organ Failure Assessment score), and mortality,
collected throughout a 2-week period. RESULTS The mean (SD) volume per blood draw was 10.3 (6.6) mL, with an average
total volume of 41.1 (39.7) mL during the 24-hour period. There was a positive
correlation between organ dysfunction and the number of blood draws (r = 0.34; P<.001) and total
volume drawn (r = 0.28; P<.001).
The mean hemoglobin concentration at ICU admission was 11.3 (2.3) g/dL, with
29% (963/3295) having a concentration of less than 10 g/dL. The transfusion
rate during the ICU period was 37.0% (1307/3534). Older patients and those
with a longer ICU length of stay were more commonly transfused. Both ICU and
overall mortality rates were significantly higher in patients who had vs had
not received a transfusion (ICU rates: 18.5% vs 10.1%, respectively; χ2 = 50.1; P<.001; overall rates: 29.0% vs
14.9%, respectively; χ2 = 88.1; P<.001).
For similar degrees of organ dysfunction, patients who had a transfusion had
a higher mortality rate. For matched patients in the propensity analysis,
the 28-day mortality was 22.7% among patients with transfusions and 17.1%
among those without (P = .02); the Kaplan-Meier log-rank
test confirmed this difference. CONCLUSIONS This multicenter observational study reveals the common occurrence of
anemia and the large use of blood transfusion in critically ill patients.
Additionally, this epidemiologic study provides evidence of an association
between transfusions and diminished organ function as well as between transfusions
and mortality.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.288.12.1499</identifier><identifier>PMID: 12243637</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Adult ; Aged ; Anemia ; Anemia - epidemiology ; Anemia - therapy ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; APACHE ; Biological and medical sciences ; Blood transfusions ; Critical care ; Critical Illness - mortality ; Epidemiology ; Erythrocyte Transfusion - statistics & numerical data ; Europe - epidemiology ; Female ; Hemoglobins - analysis ; Humans ; Intensive care medicine ; Intensive Care Units - statistics & numerical data ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Multiple Organ Failure ; Multivariate Analysis ; Risk ; Severity of Illness Index ; Survival Analysis</subject><ispartof>JAMA : the journal of the American Medical Association, 2002-09, Vol.288 (12), p.1499-1507</ispartof><rights>2002 INIST-CNRS</rights><rights>Copyright American Medical Association Sep 25, 2002</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a395t-215dbe9a8791ac748594830c87d33486c21673ff519efbce19b370c1b17078d33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.288.12.1499$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.288.12.1499$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76232,76235</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13934350$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12243637$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vincent, Jean Louis</creatorcontrib><creatorcontrib>Baron, Jean-François</creatorcontrib><creatorcontrib>Reinhart, Konrad</creatorcontrib><creatorcontrib>Gattinoni, Luciano</creatorcontrib><creatorcontrib>Thijs, Lambert</creatorcontrib><creatorcontrib>Webb, Andrew</creatorcontrib><creatorcontrib>Meier-Hellmann, Andreas</creatorcontrib><creatorcontrib>Nollet, Guy</creatorcontrib><creatorcontrib>Peres-Bota, Daliana</creatorcontrib><creatorcontrib>for the ABC Investigators</creatorcontrib><creatorcontrib>ABC (Anemia and Blood Transfusion in Critical Care) Investigators</creatorcontrib><title>Anemia and Blood Transfusion in Critically Ill Patients</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT Anemia is a common problem in critically ill patients admitted to intensive
care units (ICUs), but the consequences of anemia on morbidity and mortality
in the critically ill is poorly defined. OBJECTIVES To prospectively define the incidence of anemia and use of red blood
cell (RBC) transfusions in critically ill patients and to explore the potential
benefits and risks associated with transfusion in the ICU. DESIGN Prospective observational study conducted November 1999, with 2 components:
a blood sampling study and an anemia and blood transfusion study. SETTING AND PATIENTS The blood sampling study included 1136 patients from 145 western European
ICUs, and the anemia and blood transfusion study included 3534 patients from
146 western European ICUs. Patients were followed up for 28 days or until
hospital discharge, interinstitutional transfer, or death. MAIN OUTCOME MEASURES Frequency of blood drawing and associated volume of blood drawn, collected
over a 24-hour period; hemoglobin levels, transfusion rate, organ dysfunction
(assessed using the Sequential Organ Failure Assessment score), and mortality,
collected throughout a 2-week period. RESULTS The mean (SD) volume per blood draw was 10.3 (6.6) mL, with an average
total volume of 41.1 (39.7) mL during the 24-hour period. There was a positive
correlation between organ dysfunction and the number of blood draws (r = 0.34; P<.001) and total
volume drawn (r = 0.28; P<.001).
The mean hemoglobin concentration at ICU admission was 11.3 (2.3) g/dL, with
29% (963/3295) having a concentration of less than 10 g/dL. The transfusion
rate during the ICU period was 37.0% (1307/3534). Older patients and those
with a longer ICU length of stay were more commonly transfused. Both ICU and
overall mortality rates were significantly higher in patients who had vs had
not received a transfusion (ICU rates: 18.5% vs 10.1%, respectively; χ2 = 50.1; P<.001; overall rates: 29.0% vs
14.9%, respectively; χ2 = 88.1; P<.001).
For similar degrees of organ dysfunction, patients who had a transfusion had
a higher mortality rate. For matched patients in the propensity analysis,
the 28-day mortality was 22.7% among patients with transfusions and 17.1%
among those without (P = .02); the Kaplan-Meier log-rank
test confirmed this difference. CONCLUSIONS This multicenter observational study reveals the common occurrence of
anemia and the large use of blood transfusion in critically ill patients.
Additionally, this epidemiologic study provides evidence of an association
between transfusions and diminished organ function as well as between transfusions
and mortality.</description><subject>Adult</subject><subject>Aged</subject><subject>Anemia</subject><subject>Anemia - epidemiology</subject><subject>Anemia - therapy</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>APACHE</subject><subject>Biological and medical sciences</subject><subject>Blood transfusions</subject><subject>Critical care</subject><subject>Critical Illness - mortality</subject><subject>Epidemiology</subject><subject>Erythrocyte Transfusion - statistics & numerical data</subject><subject>Europe - epidemiology</subject><subject>Female</subject><subject>Hemoglobins - analysis</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Multiple Organ Failure</subject><subject>Multivariate Analysis</subject><subject>Risk</subject><subject>Severity of Illness Index</subject><subject>Survival Analysis</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0c1LwzAUAPAgipvTu16kCHprzetLluQ4hx-DgR7muaRtChlpqk172H9vZJOB7_IO78fjfRByDTQDSuFxq1ud5VJmkGfAlDohU-AoU-RKnpIppUqmgkk2IRchbGkMQHFOJpDnDOcopkQsvGmtTrSvkyfXdXWy6bUPzRhs5xPrk2VvB1tp53bJyrnkQw_W-CFckrNGu2CuDnlGPl-eN8u3dP3-ulou1qlGxYc0B16XRmkpFOgqjsIVk0grKWpEJudVDnOBTcNBmaasDKgSBa2gBEGFjGZGHvZ9v_ruezRhKFobKuOc9qYbQyFyAGRKRnj3D267sfdxtuKXcAZx4Rm5PaCxbE1dfPW21f2u-LtHBPcHoENcuom3qGw4OlTIkNPobvYuPuBYVRyB4g9fxHSZ</recordid><startdate>20020925</startdate><enddate>20020925</enddate><creator>Vincent, Jean Louis</creator><creator>Baron, Jean-François</creator><creator>Reinhart, Konrad</creator><creator>Gattinoni, Luciano</creator><creator>Thijs, Lambert</creator><creator>Webb, Andrew</creator><creator>Meier-Hellmann, Andreas</creator><creator>Nollet, Guy</creator><creator>Peres-Bota, Daliana</creator><creator>for the ABC Investigators</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20020925</creationdate><title>Anemia and Blood Transfusion in Critically Ill Patients</title><author>Vincent, Jean Louis ; Baron, Jean-François ; Reinhart, Konrad ; Gattinoni, Luciano ; Thijs, Lambert ; Webb, Andrew ; Meier-Hellmann, Andreas ; Nollet, Guy ; Peres-Bota, Daliana ; for the ABC Investigators</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a395t-215dbe9a8791ac748594830c87d33486c21673ff519efbce19b370c1b17078d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anemia</topic><topic>Anemia - epidemiology</topic><topic>Anemia - therapy</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>APACHE</topic><topic>Biological and medical sciences</topic><topic>Blood transfusions</topic><topic>Critical care</topic><topic>Critical Illness - mortality</topic><topic>Epidemiology</topic><topic>Erythrocyte Transfusion - statistics & numerical data</topic><topic>Europe - epidemiology</topic><topic>Female</topic><topic>Hemoglobins - analysis</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Multiple Organ Failure</topic><topic>Multivariate Analysis</topic><topic>Risk</topic><topic>Severity of Illness Index</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vincent, Jean Louis</creatorcontrib><creatorcontrib>Baron, Jean-François</creatorcontrib><creatorcontrib>Reinhart, Konrad</creatorcontrib><creatorcontrib>Gattinoni, Luciano</creatorcontrib><creatorcontrib>Thijs, Lambert</creatorcontrib><creatorcontrib>Webb, Andrew</creatorcontrib><creatorcontrib>Meier-Hellmann, Andreas</creatorcontrib><creatorcontrib>Nollet, Guy</creatorcontrib><creatorcontrib>Peres-Bota, Daliana</creatorcontrib><creatorcontrib>for the ABC Investigators</creatorcontrib><creatorcontrib>ABC (Anemia and Blood Transfusion in Critical Care) Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vincent, Jean Louis</au><au>Baron, Jean-François</au><au>Reinhart, Konrad</au><au>Gattinoni, Luciano</au><au>Thijs, Lambert</au><au>Webb, Andrew</au><au>Meier-Hellmann, Andreas</au><au>Nollet, Guy</au><au>Peres-Bota, Daliana</au><au>for the ABC Investigators</au><aucorp>ABC (Anemia and Blood Transfusion in Critical Care) Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anemia and Blood Transfusion in Critically Ill Patients</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2002-09-25</date><risdate>2002</risdate><volume>288</volume><issue>12</issue><spage>1499</spage><epage>1507</epage><pages>1499-1507</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT Anemia is a common problem in critically ill patients admitted to intensive
care units (ICUs), but the consequences of anemia on morbidity and mortality
in the critically ill is poorly defined. OBJECTIVES To prospectively define the incidence of anemia and use of red blood
cell (RBC) transfusions in critically ill patients and to explore the potential
benefits and risks associated with transfusion in the ICU. DESIGN Prospective observational study conducted November 1999, with 2 components:
a blood sampling study and an anemia and blood transfusion study. SETTING AND PATIENTS The blood sampling study included 1136 patients from 145 western European
ICUs, and the anemia and blood transfusion study included 3534 patients from
146 western European ICUs. Patients were followed up for 28 days or until
hospital discharge, interinstitutional transfer, or death. MAIN OUTCOME MEASURES Frequency of blood drawing and associated volume of blood drawn, collected
over a 24-hour period; hemoglobin levels, transfusion rate, organ dysfunction
(assessed using the Sequential Organ Failure Assessment score), and mortality,
collected throughout a 2-week period. RESULTS The mean (SD) volume per blood draw was 10.3 (6.6) mL, with an average
total volume of 41.1 (39.7) mL during the 24-hour period. There was a positive
correlation between organ dysfunction and the number of blood draws (r = 0.34; P<.001) and total
volume drawn (r = 0.28; P<.001).
The mean hemoglobin concentration at ICU admission was 11.3 (2.3) g/dL, with
29% (963/3295) having a concentration of less than 10 g/dL. The transfusion
rate during the ICU period was 37.0% (1307/3534). Older patients and those
with a longer ICU length of stay were more commonly transfused. Both ICU and
overall mortality rates were significantly higher in patients who had vs had
not received a transfusion (ICU rates: 18.5% vs 10.1%, respectively; χ2 = 50.1; P<.001; overall rates: 29.0% vs
14.9%, respectively; χ2 = 88.1; P<.001).
For similar degrees of organ dysfunction, patients who had a transfusion had
a higher mortality rate. For matched patients in the propensity analysis,
the 28-day mortality was 22.7% among patients with transfusions and 17.1%
among those without (P = .02); the Kaplan-Meier log-rank
test confirmed this difference. CONCLUSIONS This multicenter observational study reveals the common occurrence of
anemia and the large use of blood transfusion in critically ill patients.
Additionally, this epidemiologic study provides evidence of an association
between transfusions and diminished organ function as well as between transfusions
and mortality.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>12243637</pmid><doi>10.1001/jama.288.12.1499</doi><tpages>9</tpages></addata></record> |
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| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2002-09, Vol.288 (12), p.1499-1507 |
| issn | 0098-7484 1538-3598 |
| language | eng |
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| source | MEDLINE; American Medical Association Journals |
| subjects | Adult Aged Anemia Anemia - epidemiology Anemia - therapy Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy APACHE Biological and medical sciences Blood transfusions Critical care Critical Illness - mortality Epidemiology Erythrocyte Transfusion - statistics & numerical data Europe - epidemiology Female Hemoglobins - analysis Humans Intensive care medicine Intensive Care Units - statistics & numerical data Length of Stay Male Medical sciences Middle Aged Miscellaneous Multiple Organ Failure Multivariate Analysis Risk Severity of Illness Index Survival Analysis |
| title | Anemia and Blood Transfusion in Critically Ill Patients |
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