Association of age and packed red blood cell transfusion to 1-year survival--an observational study of ICU patients

Transfus Med. 2013 Aug;23(4):231-7. doi: 10.1111/tme.12010. Epub 2013 Mar 11.

Abstract

Objectives: To compare the 1-year survival for different age strata of intensive care unit (ICU) patients after receipt of packed red blood cell (PRBC) transfusions.

Background: Despite guidelines documenting risks of PRBC transfusion and data showing that increasing age is associated with ICU mortality, little data exist on whether age alters the transfusion-related risk of decreased survival.

Methods: We retrospectively examined data on 2393 consecutive male ICU patients admitted to a tertiary-care hospital from 2003 to 2009 in age strata: 21-50, 51-60, 61-70, 71-80 and >80 years. We calculated Cox regression models to determine the modifying effect of age on the impact of PRBC transfusion on 1-year survival by using interaction terms between receipt of transfusion and age strata, controlling for type of admission and Charlson co-morbidity indices. We also examined the distribution of admission haematocrit and whether transfusion rates differed by age strata.

Results: All age strata experienced statistically similar risks of decreased 1-year survival after receipt of PRBC transfusions. However, patients age >80 were more likely than younger cohorts to have haematocrits of 25-30% at admission and were transfused at approximately twice the rate of each of the younger age strata.

Discussion: We found no significant interaction between receipt of red cell transfusion and age, as variables, and survival at 1 year as an outcome.

Keywords: elderly; intensive care unit; survival; transfusion.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Erythrocyte Transfusion / mortality*
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Rate
  • Tertiary Care Centers