摘要
目的了解冠状动脉旁路移植术(CABG)围术期输血对术后结果的影响。方法回顾性分析1 420例成人CABG病例,根据围术期是否输注异体红细胞,分为输血组(n=464)和对照组(n=956);对比分析2组围术期输血对CABG后早期死亡率、并发症发生率及其对住院时间和住院费用的影响。通过多因素Logistic回归分析,探讨围术期输血及输血量是否为CABG后死亡及并发症的独立危险因素。结果 CABG后输血组和对照组的死亡率为1.08%(5/464)vs 0.31%(3/956)(P>0.05),重大并发症发生率为49.14%(228/464)vs 27.72%(265/956)(P<0.05);住院时间(d)为9.24±6.32 vs 7.63±4.38(P<0.01),住院费用(万元)为10.23±4.90 vs 8.79±3.21(P<0.01)。多因素Logistic回归分析结果显示异体输血是重大并发症的独立危险因素;而红细胞输血量是增加术后死亡率及并发症的独立危险因素。结论 CABG围术期输异体血会明显增加围术期并发症发生率,增加患者住院时间及住院费用;输血量增加则会增加CABG后患者死亡率及并发症发生率。
Objective: To investigate the impact of blood transfusion on the prognosis for patients with coronary artery bypass grafting( CABG). Methods A retrospective analysis of 1,420 consecutive CABG Cases was performed. The patients were divided into the blood transfusion group( n = 464) and the control group( n = 956) based on whether homologous red blood cells were transfused pre-operation. Treatment outcomes of the two groups were compared to study the impact of blood transfusion on perioperative mortality,major complications,hospitalization duration and total cost. Multivariable logistic regression analysis was used to predict if blood transfusion and the volume of RBCs transfused were independent risk factors for postoperative outcomes. Results There was no significant difference in mortality rates between the two groups at 1. 08%( 5/464)vs 0. 31%( 3/956)( P 0. 05). The blood transfusion group had higher morbidity ratio compared to the control group at 49. 14%( 228/464) vs 27. 72%( 265/956)( P〈0. 05). The blood transfusion group also presents a longer hospitalization duration at 9. 24±6. 32 d vs 7. 63±4. 38 d( P〈0. 01) and higher hospitalization costs at 102,300± 49,000 vs 87,900± 32,100( P〈0. 01). This analysis indicated that perioperative blood transfusion was an independent risk factor for postoperative morbidity and the volume of RBCs transfused was an independent risk factor for postoperative mortality and morbidity. Conclusion Perioperative blood transfusion can significantly increase perioperative major complications,and lead to prolonged hospitalization period with a higher cost. The increase of the RBCs transfused is related to higher mortality and morbidity.
出处
《中国输血杂志》
北大核心
2017年第12期1353-1356,共4页
Chinese Journal of Blood Transfusion
关键词
冠状动脉旁路移植术
围术期输血
异体血
术后死亡率
术后并发症
住院时间
住院费用
CABG
perioperative blood transfusion
homologous blood
postoperative mortality
postoperative complications
hospital stay
hospitalization costs