Anaemia and transfusion in nonagenarians undergoing emergency, non-traumatic surgery: a prospective observational study

作者：Pelavski A D^*; de Miguel M; Lacasta A; Rochera M I; Roca M

来源：Transfusion Medicine, 2013, 23(4): 238-244.

DOI：10.1111/tme.12011

• 80 and over
• aged
• blood transfusion
• emergency medicine
• operative
• surgical procedures

ObjectivesTo characterise transfusion and determine its main predictors in nonagenarians undergoing non-elective, non-traumatic surgery. Simultaneously, we compared nonagenarians to a similar, but younger sample, as far as the transfusional policy is concerned. %26lt;br%26gt;BackgroundPerioperative anaemia and transfusion are currently topical, but little is known about them in this population. %26lt;br%26gt;MethodsIn this prospective observational study, we recruited 135 patients older than 90 who underwent a non-elective, non-traumatic procedure, between 2006 and 2011. A descriptive statistical analysis was performed and a logistic regression model developed. As a control sample, we used a similar number of patients in their third age (between 65 and 85 years old), who underwent the same procedure, during the same period. %26lt;br%26gt;ResultsThirty-five per cent of the nonagenarians were transfused. The main independent factors associated with transfusion were anaemia (OR 6%26lt;bold%26gt;77%26lt;/bold%26gt;, P%26lt;0%26lt;bold%26gt;01%26lt;/bold%26gt;), a coexisting neoplasm (OR 10%26lt;bold%26gt;99%26lt;/bold%26gt;, P%26lt;0%26lt;bold%26gt;01%26lt;/bold%26gt;) and the need for an exploratory laparotomy (OR 3%26lt;bold%26gt;05%26lt;/bold%26gt;, P=0%26lt;bold%26gt;01%26lt;/bold%26gt;). When comparing the nonagenarians to the younger group, we found a significant difference in their basal health status and the mortality rate (P%26lt;0%26lt;bold%26gt;01%26lt;/bold%26gt;), but the transfusion policy did not differ substantially, except for the haemoglobin threshold (P=0%26lt;bold%26gt;01%26lt;/bold%26gt;). %26lt;br%26gt;ConclusionsThe independent transfusion predictors in nonagenarians should be taken into account for cross-matching. Transfusional policy being similar between nonagenarians and third-aged patients; the differences in thresholds were due to the differences in the populations.

• 出版日期2013-8