J Med Assoc Thai 2014; 97 (2):203

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Incidence of Red Blood Cell Transfusion in Mechanically Ventilated Surgical Patients at Siriraj Hospital
Piriyapatsom A Mail, Chaiwat O , Sak-aroonchai J , Suwannasri W , Kanavitoon S

Background: Anemia is commonly encountering surgical critically ill patients. The incidence of red blood cell (RBC) transfusion and transfusion trigger in this population has not been previously reported in a large tertiary care center in Thailand.

Objective: To describe the incidence of RBC transfusion and transfusion trigger and to determine the factors and outcomes associated with RBC transfusion.

Material and Method: Data of 288 adult surgical patients requiring mechanical ventilation for >24 hours was retrospectively reviewed. Patient characteristic, outcomes, and transfusion data were collected.

Results: The incidence of RBC transfusion was 83.0% (95% confidence interval (CI) 78.0-87.0%). The mean hemoglobin level before RBC transfusion was 8.7±1.2 g/dL. Patients who received RBC transfusion had significantly higher morbidity and mortality when compared with those who did not. Independent factors associated with RBC transfusion were low body weight, high Sequential Organ Failure Assessment (SOFA) score, and low hemoglobin level on admission (adjusted odds ratio 0.97, 1.19, and 0.60. respectively).

Conclusion: In critically ill adult surgical patients, the incidence of RBC transfusion and transfusion trigger remained within high threshold. Large randomized controlled studies are warranted to confirm potential benefit of RBC transfusion in surgical critically ill patients.

Keywords: Anemia, Blood transfusion, Critically ill, Surgical patients

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