Duration of red blood cells storage and outcome in critically ill patients

Cecile Aubron; Michael Bailey; Zoe McQuilten; David Pilcher; Colin Hegarty; Anthony Martinelli; Geoff Magrin; David Irving; D Jamie Cooper; Rinaldo Bellomo

doi:10.1016/j.jcrc.2014.01.006

Duration of red blood cells storage and outcome in critically ill patients

J Crit Care. 2014 Jun;29(3):476.e1-8. doi: 10.1016/j.jcrc.2014.01.006. Epub 2014 Jan 13.

Authors

Affiliations

¹ The Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia. Electronic address: cecile.aubron@monash.edu.
² The Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia.
³ The Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia; Research and Development, The Australian Red Cross Blood Service, Melbourne,Victoria 3004, Australia.
⁴ The Intensive Care Unit of The Austin Hospital, Studley Road, Heidelberg, Victoria 3084, Melbourne, Australia.
⁵ The Transfusion Service of The Austin Hospital, Heidelberg, Victoria 3084, Melbourne, Australia.
⁶ The Transfusion Service of The Alfred Hospital, Melbourne, Victoria 3004, Australia.
⁷ Research and Development, The Australian Red Cross Blood Service, Melbourne,Victoria 3004, Australia.

PMID: 24559574
DOI: 10.1016/j.jcrc.2014.01.006

Abstract

Purpose: There is conflicting evidence on the effect of red blood cells (RBC) storage duration and clinical outcomes. We aimed to investigate the association between RBC storage duration and clinical outcomes in patients admitted to the intensive care unit (ICU).

Materials and methods: We retrospectively (2001-2011) studied adults admitted to the ICUs of 2 hospitals who received RBC. Using the mean, maximum and minimum age of RBC units transfused, we evaluated the association between RBC storage duration and mortality. We also analyzed the association between mean age of RBC units and length of stay (LOS) in survivors. We performed sensitivity analyses in patients who only received RBC in ICU and who only received leukodepleted RBC.

Results: We studied 8416 patients who received a median of 4 (interquartile range, 2-7) RBC units. After multivariate analysis, age of RBC was not independently associated with mortality, including in the subgroup analyses. Furthermore, there was no clinically relevant relationship between mean RBC age and LOS.

Conclusions: RBC storage duration was not associated with increased mortality nor ICU and hospital LOS. These results support the view that the effect of RBC storage duration on outcomes in critically ill patients is uncertain.

Keywords: Critically ill patients; Intensive care unit; Length of stay; Morbidity; Mortality; Outcome; Red blood cells storage duration; Transfusion.

MeSH terms

Aged
Critical Illness* / mortality
Erythrocyte Transfusion / statistics & numerical data*
Erythrocytes*
Female
Hospital Mortality*
Humans
Intensive Care Units
Length of Stay*
Male
Middle Aged
Multivariate Analysis
Retrospective Studies
Specimen Handling*
Time Factors