Avoidance of Blood Transfusion to Patients Suffering From Myocardial Injury and Severe Anemia Is Associated With Increased Long-Term Mortality. Issue 38 (September 2015)

• Record Type: Journal Article
• Authors: Barbarova, Irina; Klempfner, Robert; Rapoport, Avigal; Wasserstrum, Yishay; Goren, Idan; Kats, Ana; Segal, Gad; Bil., Jacek
• Is Part Of: Medicine. Volume 94:Issue 38(2015)
• Publication Date: 2015-09
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000001635
• Languages: English
• ISSNs: 0025-7974

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Abstract</title> <p>Myocardial injury and anemia are common among patients in internal medicine departments. Nevertheless, the level of anemia in which blood should be given to these patients is ill defined.</p> <p>We conducted a retrospective, cohort analysis.</p> <p>A total of 209 patients hospitalized to internal medicine, with myocardial injury (troponin I > 0.2 mcg/L, not diagnosed as ACS, acute coronary syndrome) and anemia (Hb < 10 g/dL, without overt bleeding) were included. The overall in-hospital mortality rate was 20.7%. A total of 37 patients (17.8%) had severe anemia (Hb < 8 g/dL). A total of 73 patients (34.9%) were transfused. Severe anemia was not associated with increased long-term mortality in the whole cohort while survival of patients with severe anemia that were not transfused was significantly reduced compared to transfused patients (44% vs 80%; <italic>P</italic> = 0.03). Mortality rates were similar for all patients with Hb ≥ 8 g/dL, regardless of transfusion (54% vs 49%; <italic>P</italic> = 0.60). Consistently, lack of blood transfusion in patients with severe anemia was independently associated with a 2.27 (1.08–4.81) greater adjusted risk of all-cause mortality (<italic>P</italic>-value for interaction = 0.04), whereas it did not significantly increase in patients with Hb ≥ 8 g/dL.</p> <p>Avoidance of blood transfusion is associated with unfavorable outcomes among patients with myocardial injury and severe anemia.</p> </sec> </abstract>