naa a22 4500 510800262 CHVBK 20180411083352.0 cr unu---uuuuu 180411e20130401xx s 000 0 eng 10.1007/s12028-012-9777-y doi (NATIONALLICENCE)springer-10.1007/s12028-012-9777-y Blood Transfusion is an Important Predictor of Hospital Mortality Among Patients with Aneurysmal Subarachnoid Hemorrhage [Elektronische Daten] [Emir Festic, Alejandro Rabinstein, William Freeman, Elizabeth Mauricio, Maisha Robinson, Jay Mandrekar, Abba Zubair, Augustine Lee, Ognjen Gajic] Background: Red blood cell (RBC) transfusion after aneurysmal subarachnoid hemorrhage (aSAH) has been associated with increased mortality but prior studies have not adequately adjusted for transfusion-indication bias. Methods: This is a retrospective study of consecutive aSAH patients admitted to the intensive care units of two academic medical centers over a 7-year period. Data collection included demographics, World Federation of Neurosurgical Surgeons score (WFNS), modified Fisher score (mFisher), admission and nadir hemoglobin (Hb) level, vasospasm, cerebral infarction, acute lung injury, and hospital mortality. The association between RBC transfusion and mortality was evaluated using a multivariate logistic regression analysis using the propensity for RBC transfusion as a covariate. Results: We identified 318 patients. The median age was 54years (46, 65), and 204 (64%) were females. Hospital mortality was 13% (42/318). Seventy-two (23%) patients were transfused. Predictors of transfusion were admit and nadir Hb levels (p<0.001), age (p=0.02), gender (0.008), WFNS score (p<0.001), mFisher score (p=0.009), surgical versus endovascular treatment (p<0.001) and moderate to severe vasospasm (p=0.025) were predictors of transfusion. After adjustment for probability of receiving RBC transfusion, APACHE IV and nadir Hb, transfusion remained independently associated with hospital mortality (OR 3.16, 95% CI=1.02-9.69, p=0.047). Conclusions: Among patients with aSAH, RBC transfusion was independently associated with an increased mortality after adjustment for the most common clinical indications for transfusion. Springer Science+Business Media, LLC, 2012 Transfusion nationallicence Subarachnoid hemorrhage nationallicence Mortality nationallicence Anemia nationallicence Vasospasm nationallicence Festic Emir Department of Critical Care Medicine, Mayo Clinic, 4500, San Pablo Rd, 32224, Jacksonville, FL, USA aut Rabinstein Alejandro Department of Neurology, Mayo Clinic, Rochester, MN, USA aut Freeman William Department of Critical Care Medicine, Mayo Clinic, 4500, San Pablo Rd, 32224, Jacksonville, FL, USA aut Mauricio Elizabeth Department of Neurology, Mayo Clinic, Rochester, MN, USA aut Robinson Maisha Department of Neurology, Mayo Clinic, Rochester, MN, USA aut Mandrekar Jay Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA aut Zubair Abba Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA aut Lee Augustine Department of Critical Care Medicine, Mayo Clinic, 4500, San Pablo Rd, 32224, Jacksonville, FL, USA aut Gajic Ognjen Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA aut Neurocritical Care Humana Press Inc 18/2(2013-04-01), 209-215 1541-6933 18:2<209 2013 18 12028 https://doi.org/10.1007/s12028-012-9777-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9777-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Festic Emir Department of Critical Care Medicine, Mayo Clinic, 4500, San Pablo Rd, 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Rabinstein Alejandro Department of Neurology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Freeman William Department of Critical Care Medicine, Mayo Clinic, 4500, San Pablo Rd, 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Mauricio Elizabeth Department of Neurology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Robinson Maisha Department of Neurology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Mandrekar Jay Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Zubair Abba Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Lee Augustine Department of Critical Care Medicine, Mayo Clinic, 4500, San Pablo Rd, 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Gajic Ognjen Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/2(2013-04-01), 209-215 1541-6933 18:2<209 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer