Journal article
Length of Storage of Red Blood Cells and Patient Survival After Blood Transfusion A Binational Cohort Study
Annals of internal medicine, v 166(4), pp 248-256
21 Feb 2017
PMID: 27992899
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Possible negative effects, including increased mortality, among persons who receive stored red blood cells (RBCs) have recently garnered considerable attention. Despite many studies, including 4 randomized trials, no consensus exists.
Objective: To study the association between the length of RBC storage and mortality in a large population-based cohort of patients who received transfusions, allowing detection of small yet clinically significant effects.
Design: Binational cohort study.
Setting: All transfusion recipients in Sweden and Denmark.
Patients: 854 862 adult patients who received transfusions from 2003 to 2012.
Measurements: Patients were followed from first blood transfusion. Relative and absolute risks for death in 30 days or 1 year in relation to length of RBC storage were assessed by using 3 independent analytic approaches. All analyses were conducted by using Cox proportional hazards regression.
Results: Regardless of the analytic approach, no association was found between the length of RBC storage and mortality. The difference in 30-day cumulative mortality between patients receiving blood stored for 30 to 42 days and those receiving blood stored for 10 to 19 days was -0.2% (95% CI, -0.5% to 0.1%). Even among patients who received more than 6 units of RBCs stored for 30 days or longer, the hazard ratio of death was 1.00 (CI, 0.96 to 1.05) compared with those who received no such units.
Limitation: Observational study; risk of confounding by indication.
Conclusion: Consistent with previous randomized trials, this study found no association between the length of storage of transfused RBCs and patient mortality. Results were homogeneous, with differences in absolute mortality consistently less than 1% among the most extreme exposure categories. These findings suggest that the current practice of storing RBCs for up to 42 days does not need to be changed.
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Details
- Title
- Length of Storage of Red Blood Cells and Patient Survival After Blood Transfusion A Binational Cohort Study
- Creators
- Marit Halmin - Karolinska InstituteKlaus Rostgaard - Statens Serum InstitutBrian K. Lee - Drexel UniversityAgneta Wikman - Karolinska University HospitalRut Norda - Uppsala University HospitalKaspar Rene Nielsen - Deutsche Klinik für DiagnostikOle B. Pedersen - Naestved Hosp, Dept Clin Immunol, DK-4700 Naestved, DenmarkJacob Holmqvist - Karlstad Central HospitalHenrik Hjalgrim - Statens Serum InstitutGustaf Edgren - Karolinska Institute
- Publication Details
- Annals of internal medicine, v 166(4), pp 248-256
- Publisher
- Amer Coll Physicians
- Number of pages
- 14
- Grant note
- Danish Council for Independent Research; Det Frie Forskningsrad (DFF) Strategic Research Program in Epidemiology at Karolinska Institutet Swedish Heart-Lung Foundation Swedish Society for Medical Research Swedish Research Council; European Commission
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000394786700014
- Scopus ID
- 2-s2.0-85020328366
- Other Identifier
- 991019168787904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Hematology