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Early Blood Transfusions in Sepsis: Unchanged Survival and Increased Costs.

Publication ,  Journal Article
Raghunathan, K; Singh, M; Nathanson, BH; Bennett-Guerrero, E; Lindenauer, PK
Published in: Am J Crit Care
May 2018

BACKGROUND: Early red blood cell transfusions are a common treatment for adults hospitalized for sepsis without shock. However, their utility and association with mortality and costs have not been well studied. OBJECTIVES: To examine early transfusion rates for patients with sepsis treated outside intensive care units, and to find a correlation between transfusion rates and survival rates and costs. METHODS: Data were obtained from hospital members of the Premier Healthcare Alliance that admitted at least 50 adults with sepsis between January 1, 2006, and December 31, 2010. Early transfusion rates at each hospital were calculated as the observed incidence of allogeneic red blood cells administered by hospital day 2. A multivariable logistic regression model was constructed to estimate the expected or risk-adjusted transfusion rates, mortality rates, and costs. RESULTS: A total of 256 396 adults were hospitalized with sepsis without major bleeding or surgery at 364 US hospitals. Approximately 84% of all patients admitted with sepsis, without vasopressor therapy, were treated outside the intensive care unit (by day 2). The mean institutional early transfusion rate was 6.9%. After risk standardization, the median (interquartile range) transfusion rate was 6.7% (5.8%-7.6%), mortality rate was 15.5% (13.1%-18.1%), and costs were $13 333 ($11 939-$14 986). Early transfusion rates were not correlated with mortality but were modestly positively correlated with costs (Spearman ρ = 0.157; P = .003). CONCLUSIONS: Early transfusion rates during hospitalization for sepsis without shock varied widely across the hospitals. Transfusion rates were associated with increased costs but not with mortality rates.

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Published In

Am J Crit Care

DOI

EISSN

1937-710X

Publication Date

May 2018

Volume

27

Issue

3

Start / End Page

205 / 211

Location

United States

Related Subject Headings

  • Time Factors
  • Severity of Illness Index
  • Sepsis
  • Nursing
  • Middle Aged
  • Male
  • Logistic Models
  • Length of Stay
  • Intensive Care Units
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Raghunathan, K., Singh, M., Nathanson, B. H., Bennett-Guerrero, E., & Lindenauer, P. K. (2018). Early Blood Transfusions in Sepsis: Unchanged Survival and Increased Costs. Am J Crit Care, 27(3), 205–211. https://doi.org/10.4037/ajcc2018303
Raghunathan, Karthik, Mandeep Singh, Brian H. Nathanson, Elliott Bennett-Guerrero, and Peter K. Lindenauer. “Early Blood Transfusions in Sepsis: Unchanged Survival and Increased Costs.Am J Crit Care 27, no. 3 (May 2018): 205–11. https://doi.org/10.4037/ajcc2018303.
Raghunathan K, Singh M, Nathanson BH, Bennett-Guerrero E, Lindenauer PK. Early Blood Transfusions in Sepsis: Unchanged Survival and Increased Costs. Am J Crit Care. 2018 May;27(3):205–11.
Raghunathan, Karthik, et al. “Early Blood Transfusions in Sepsis: Unchanged Survival and Increased Costs.Am J Crit Care, vol. 27, no. 3, May 2018, pp. 205–11. Pubmed, doi:10.4037/ajcc2018303.
Raghunathan K, Singh M, Nathanson BH, Bennett-Guerrero E, Lindenauer PK. Early Blood Transfusions in Sepsis: Unchanged Survival and Increased Costs. Am J Crit Care. 2018 May;27(3):205–211.

Published In

Am J Crit Care

DOI

EISSN

1937-710X

Publication Date

May 2018

Volume

27

Issue

3

Start / End Page

205 / 211

Location

United States

Related Subject Headings

  • Time Factors
  • Severity of Illness Index
  • Sepsis
  • Nursing
  • Middle Aged
  • Male
  • Logistic Models
  • Length of Stay
  • Intensive Care Units
  • Humans