TY - JOUR
T1 - Long-term survival And quality Of life after transfusion-associated pulmonary edema in critically III medical patients
AU - Li, Guangxi
AU - Kojicic, Marija
AU - Reriani, Martin K.
AU - Fernández Pérez, Evans R.
AU - Thakur, Lokendra
AU - Kashyap, Rahul
AU - Van Buskirk, Camille M.
AU - Gajic, Ognjen
N1 - Funding Information:
Funding/Support: This work was supported by grants from the National Heart Lung and Blood Institute, Special Center of Research in Transfusion Medicine [Grant HL81027 ] and the National Institutes of Health [Grant HL78743 ].
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Background: Transfusion-related acute lung injury (TKALI) and transfusion-associated circulatory overload (TACO) commonly complicate transfusion in critically ill patients. Prior outcome studies of TACO and TKALI have focused on short-term morbidity and mortality, but the longterm survival and quality of life (QOL) of these patients remain unknown. Methods: In a nested case-control study, we compared survival and QOL between critically ill medical patients who developed pulmonary edema after transfusion (TKALI or TACO) and medical critically ill transfused controls, matched by age, gender, and admission diagnostic group. QOL in survivors was assessed with a 36-item short form health survey I year after initial hospitalization. Results: Hospital, 1-year, and 2-year mortality among the 74 TRALI cases and 74 matched controls were 43.2% vs 24.3% (P= .020), 63.8% vs 46.4% (P= .037) and 74.3% vs 54.3% (P= .031), whereas among the 51 TACO cases and 51 matched controls these values were 7.8% vs 11.8% (P= .727), 38.0% vs 28.0% (P= .371), and 44.9% vs 38.8% (P= .512). When adjusted for age and baseline severity of illness in a Cox proportional hazard analysis, the development of TKALI remained associated with decreased survival (hazard ratio 1.86; 95% CI, 1.19-2.93; P = .006). Both TRALI (P = .006, P = .03) and TACO (P = .03, P = .049) were associated with prolonged ICU and hospital lengths of stay. Conclusions: In critically ill medical patients, development of TRALI, but not TACO, is independently associated with decreased long-term survival.
AB - Background: Transfusion-related acute lung injury (TKALI) and transfusion-associated circulatory overload (TACO) commonly complicate transfusion in critically ill patients. Prior outcome studies of TACO and TKALI have focused on short-term morbidity and mortality, but the longterm survival and quality of life (QOL) of these patients remain unknown. Methods: In a nested case-control study, we compared survival and QOL between critically ill medical patients who developed pulmonary edema after transfusion (TKALI or TACO) and medical critically ill transfused controls, matched by age, gender, and admission diagnostic group. QOL in survivors was assessed with a 36-item short form health survey I year after initial hospitalization. Results: Hospital, 1-year, and 2-year mortality among the 74 TRALI cases and 74 matched controls were 43.2% vs 24.3% (P= .020), 63.8% vs 46.4% (P= .037) and 74.3% vs 54.3% (P= .031), whereas among the 51 TACO cases and 51 matched controls these values were 7.8% vs 11.8% (P= .727), 38.0% vs 28.0% (P= .371), and 44.9% vs 38.8% (P= .512). When adjusted for age and baseline severity of illness in a Cox proportional hazard analysis, the development of TKALI remained associated with decreased survival (hazard ratio 1.86; 95% CI, 1.19-2.93; P = .006). Both TRALI (P = .006, P = .03) and TACO (P = .03, P = .049) were associated with prolonged ICU and hospital lengths of stay. Conclusions: In critically ill medical patients, development of TRALI, but not TACO, is independently associated with decreased long-term survival.
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U2 - 10.1378/chest.09-0841
DO - 10.1378/chest.09-0841
M3 - Article
C2 - 19837827
AN - SCOPUS:77950845147
SN - 0012-3692
VL - 137
SP - 783
EP - 789
JO - Chest
JF - Chest
IS - 4
ER -