Association between in-ICU red blood cells transfusion and 1-year mortality in ICU survivors
Alice Blet,
Joel B. McNeil,
Julie Josse,
Bernard Cholley,
Raphaël Cinotti,
Gad Cotter,
Agnès Dauvergne,
Beth Davison,
Kévin Duarte,
Jacques Duranteau,
Marie-Céline Fournier,
Etienne Gayat,
Samir Jaber,
Sigismond Lasocki,
Thomas Merkling,
Katell Peoc’h,
Imke Mayer,
Malha Sadoune,
Pierre-François Laterre,
Romain Sonneville,
Lorraine Ware,
Alexandre Mebazaa,
Antoine Kimmoun
Affiliations
Alice Blet
Université Paris Cité, Department of Anesthesiology, Critical Care and Burn Unit, INSERM, UMR-S 942, MASCOT, FCRIN INI-CRCT, Hôpitaux Universitaires Saint Louis – Lariboisière, Assistance Publique – Hôpitaux de Paris
Joel B. McNeil
Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, University School of Medicine, Nashville
Julie Josse
Université de Montpellier, IDESP-Institut Desbrest d’Épidémiologie et de Santé Publique, PREMEDICAL - Médecine de Précision Par Intégration de Données et Inférence Causale, CRISAM- Inria Sophia Antipolis – Méditerranée
Bernard Cholley
Université Paris Cité, INSERM UMR_S 1140 “Innovations Thérapeutiques en Hémostase”
Raphaël Cinotti
University of Nantes, Department of Anesthesia and Critical Care, Hôtel Dieu, Intensive Care Unit, University Hospital of Nantes
Gad Cotter
Momentum Research, Inc.
Agnès Dauvergne
Université Paris Cité, Department of Biochemistry, Assistance Publique – Hôpitaux de Paris, Hôpital Beaujon
Beth Davison
Momentum Research, Inc.
Kévin Duarte
Université de Lorraine, INSERM 1433 CIC-P CHRU de Nancy, Inserm U1116 and FCRIN INI-CRCT
Jacques Duranteau
Université Paris-Sud, Anesthesia and Intensive Care Department, Assistance Publique Hôpitaux de Paris, Hôpital de Bicêtre
Marie-Céline Fournier
Université Paris Cité, Department of Anesthesiology, Critical Care and Burn Unit, INSERM, UMR-S 942, MASCOT, FCRIN INI-CRCT, Hôpitaux Universitaires Saint Louis – Lariboisière, Assistance Publique – Hôpitaux de Paris
Etienne Gayat
Université Paris Cité, Department of Anesthesiology, Critical Care and Burn Unit, INSERM, UMR-S 942, MASCOT, FCRIN INI-CRCT, Hôpitaux Universitaires Saint Louis – Lariboisière, Assistance Publique – Hôpitaux de Paris
Samir Jaber
Université de Montpellier, Department of Anesthesia and Intensive Care Unit, PhyMedExp, INSERM U1046, CNRS UMR, 9214, CHRU de Montpellier, Hôpital Saint Eloi
Sigismond Lasocki
Université d’Angers, Department of Anesthesia and Intensive Care Unit, CHU d’Angers
Thomas Merkling
Université de Lorraine, INSERM 1433 CIC-P CHRU de Nancy, Inserm U1116 and FCRIN INI-CRCT
Katell Peoc’h
Université Paris Cité, Department of Biochemistry, CRI INSERM UMR1149, HUPNVS, Assistance Publique – Hôpitaux de Paris
Imke Mayer
Institute for Public Health, Charité – Universitätsmedizin Berlin
Malha Sadoune
Université Paris Cité, Department of Anesthesiology, Critical Care and Burn Unit, INSERM, UMR-S 942, MASCOT, FCRIN INI-CRCT, Hôpitaux Universitaires Saint Louis – Lariboisière, Assistance Publique – Hôpitaux de Paris
Pierre-François Laterre
Intensive Care Unit, Clinique Universitaire St Luc UCL
Romain Sonneville
Université Paris Cité, Department of Intensive Care Medicine, INSERM UMR1148, HUPNVS, Assistance Publique – Hôpitaux de Paris
Lorraine Ware
Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, University School of Medicine, Nashville
Alexandre Mebazaa
Université Paris Cité, Department of Anesthesiology, Critical Care and Burn Unit, INSERM, UMR-S 942, MASCOT, FCRIN INI-CRCT, Hôpitaux Universitaires Saint Louis – Lariboisière, Assistance Publique – Hôpitaux de Paris
Antoine Kimmoun
Université de Lorraine, CHRU de Nancy, Intensive Care Medicine Babois, INSERM U1116, FCRIN INI-CRCT
Abstract Background Impact of in-ICU transfusion on long-term outcomes remains unknown. The purpose of this study was to assess in critical-care survivors the association between in-ICU red blood cells transfusion and 1-year mortality. Methods FROG-ICU, a multicenter European study enrolling all-comers critical care patients was analyzed (n = 1551). Association between red blood cells transfusion administered in intensive care unit and 1-year mortality in critical care survivors was analyzed using an augmented inverse probability of treatment weighting-augmented inverse probability of censoring weighting method to control confounders. Results Among the 1551 ICU-survivors, 42% received at least one unit of red blood cells while in intensive care unit. Patients in the transfusion group had greater severity scores than those in the no-transfusion group. According to unweighted analysis, 1-year post-critical care mortality was greater in the transfusion group compared to the no-transfusion group (hazard ratio (HR) 1.78, 95% CI 1.45–2.16). Weighted analyses including 40 confounders, showed that transfusion remained associated with a higher risk of long-term mortality (HR 1.21, 95% CI 1.06–1.46). Conclusions Our results suggest a high incidence of in-ICU RBC transfusion and that in-ICU transfusion is associated with a higher 1-year mortality among in-ICU survivors. Trial registration ( NCT01367093 ; Registered 6 June 2011). Graphic Abstract
