OBJECTIVE: To test the hypothesis that red blood cell (RBC) transfusions in preterm infants are associated with increased intra-hospital mortality. STUDY DESIGN: Variables associated with death were studied with Cox regression analysis in a prospective cohort of preterm infants with birth weight <1500 g in the Brazilian Network on Neonatal Research. Intra-hospital death and death after 28 days of life were analyzed as dependent variables. Independent variables were infant demographic and clinical characteristics and RBC transfusions. RESULTS: Of 1077 infants, 574 (53.3%) received at least one RBC transfusion during the hospital stay. The mean number of transfusions per infant was 3.3 ± 3.4, with 2.1 ± 2.1 in the first 28 days of life. Intra-hospital death occurred in 299 neonates (27.8%), and 60 infants (5.6%) died after 28 days of life. After adjusting for confounders, the relative risk of death during hospital stay was 1.49 in infants who received at least one RBC transfusion in the first 28 days of life, compared with infants who did not receive a transfusion. The risk of death after 28 days of life was 1.89 times higher in infants who received more than two RBC transfusions during their hospital stay, compared with infants who received one or two transfusions. CONCLUSION: Transfusion was associated with increased death, and transfusion guidelines should consider risks and benefits of transfusion.
OBJECTIVE: To test the hypothesis that red blood cell (RBC) transfusions in preterm infants are associated with increased intra-hospital mortality. STUDY DESIGN: Variables associated with death were studied with Cox regression analysis in a prospective cohort of preterm infants with birth weight <1500 g in the Brazilian Network on Neonatal Research. Intra-hospital death and death after 28 days of life were analyzed as dependent variables. Independent variables were infant demographic and clinical characteristics and RBC transfusions. RESULTS: Of 1077 infants, 574 (53.3%) received at least one RBC transfusion during the hospital stay. The mean number of transfusions per infant was 3.3 ± 3.4, with 2.1 ± 2.1 in the first 28 days of life. Intra-hospital death occurred in 299 neonates (27.8%), and 60 infants (5.6%) died after 28 days of life. After adjusting for confounders, the relative risk of death during hospital stay was 1.49 in infants who received at least one RBC transfusion in the first 28 days of life, compared with infants who did not receive a transfusion. The risk of death after 28 days of life was 1.89 times higher in infants who received more than two RBC transfusions during their hospital stay, compared with infants who received one or two transfusions. CONCLUSION: Transfusion was associated with increased death, and transfusion guidelines should consider risks and benefits of transfusion.
Authors: Ursula Guillén; James J Cummings; Edward F Bell; Shigerharu Hosono; Axel R Frantz; Rolf F Maier; Robin K Whyte; Elaine Boyle; Max Vento; John A Widness; Haresh Kirpalani Journal: Semin Perinatol Date: 2012-08 Impact factor: 3.300
Authors: E Henry; R D Christensen; M J Sheffield; L D Eggert; P D Carroll; S D Minton; D K Lambert; S J Ilstrup Journal: J Perinatol Date: 2014-09-25 Impact factor: 2.521
Authors: Patrick D Carroll; M Bridget Zimmerman; Demet Nalbant; Earl L Gingerich; Guohua An; Gretchen A Cress; Peter Veng-Pedersen; John A Widness Journal: Neonatology Date: 2020-06-19 Impact factor: 4.035
Authors: Matthew R Rosebraugh; John A Widness; Demet Nalbant; Gretchen Cress; Peter Veng-Pedersen Journal: Pediatr Res Date: 2013-11-11 Impact factor: 3.756