1237. Red blood cell transfusions are associated with lower mortality in patients with severe sepsis and septic shock: a propensity-matched analysis
Session: Poster Abstract Session: Sepsis and Critical Care
Saturday, October 22, 2011
Room: Poster Hall B1
Background: Blood transfusion in critically ill patients could be associated with worse outcomes, but these effects have not been investigated specifically in patients with severe sepsis and septic shock. Aim of this study is to evaluate the effects of transfusions in patients with severe sepsis and septic shock on mortality.

Methods: We retrospectively analyzed the prospectively collected data from all adult patients (≥ 18 years old) with community acquired severe sepsis and septic shock admitted to 23 medical and surgical intensive care units (ICUs) in 12 teaching hospitals of Korea from April, 2005 to February, 2009. Further analysis was done on a case-control subgroup matched by propensity score.

Results: Of 1,054 patients, 407 patients (38.6%) received blood transfusion in the ICU and their mean admitting hemoglobin level was 10.3±2.5 g/dl. Theses patients were more likely to be male, and to have cancer, trauma, renal, liver, or hematologic diseases, skin and soft tissue infection, and less likely to have urinary tract infection. Transfused patients had higher 28-day and in-hospital mortality rates (17.3% vs. 32.7%; p<0.001, 20.3% vs. 41.3%; p<0.001, respectively) and a longer duration of hospital stay (21.2±37.7 days vs. 29.8±36.6 days; p<0.001), but they were also more severely ill at admission (lower systolic blood pressure, higher Acute Physiology and Chronic Health Evaluation II score, and Sequential Organ Failure Assessment score at admission). In 152 pairs matched according to the propensity score, there were lower risk of 7-day (27.0% vs. 9.2%; p<0.001), 28-day (38.8% vs. 24.3%; p=0.007), and in-hospital mortality rates (42.8% vs. 31.6%; p=0.044) in transfused patients. Transfused patients had a longer hospital length of stay (19.7±28.6 days vs. 32.6±41.9 days; p=0.002).

Conclusion: In this observational study, blood transfusions were associated with a lower risk of mortality in patient with severe sepsis and septic shock.


Subject Category: J. Clinical practice issues

Dae Won Park, MD1,2, Byoung-Chul Chun, MD3, Soon-sun Kwon4, Young Kyung Yoon, M.D., Ph.D.2, Jang Wook Sohn, MD5, Kyong Ran Peck, MD6, Young Hwa Choi, MD7, Jun Yong Choi, MD8, Sang Il Kim, MD9, Joong Sik Eom, MD10, Hyo Youl Kim, MD, PhD11, Hee Jin Cheong, MD2, Young Goo Song, MD12, Hee Jung Choi, MD13, Yang Soo Kim, MD, PhD14, June Myung Kim, MD15 and Min Ja Kim, MD5, (1)Infectious Diseases, Korea University Ansan Hospital, Ansan, South Korea, (2)Korea Univ. Coll. of Med., Seoul, South Korea, (3)Preventive Medicine, Korea Univ. Coll. of Med., Seoul, South Korea, (4)Biostatics, Korea Univ. Coll. of Med., Seoul, South Korea, (5)Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea, Seoul, South Korea, (6)Division of Infectious Diseases, Samsung Medical Center, Seoul, South Korea, (7)Ajou University College of Medicine, Suwon, South Korea, (8)Yonsei Univ. Coll. of Med., Seoul, South Korea, (9)Catholic medical university, Seoul, South Korea, (10)Dept. of Internal Med, Hallym Univ. Med. Ctr, Seoul, South Korea, (11)Division of Infectious Diseases, Yonsei University Wonju College of Medicine, Wonju, South Korea, (12)Yonsei Univ. Coll. of Med., Seoul, Korea, Republic of, (13)Ewha Womans University, Seoul, South Korea, (14)Division of Infectious Disease, Asan Medical Center, Seoul, South Korea, (15)Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea

Disclosures:

D. W. Park, None

B. C. Chun, None

S. S. Kwon, None

Y. K. Yoon, None

J. W. Sohn, None

K. R. Peck, None

Y. H. Choi, None

J. Y. Choi, None

S. I. Kim, None

J. S. Eom, None

H. Y. Kim, None

H. J. Cheong, None

Y. G. Song, None

H. J. Choi, None

Y. S. Kim, None

J. M. Kim, None

M. J. Kim, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.