住院患者输血相关循环超负荷的危险因素以及与临床结局的关系分析  

Risk factors of transfusion⁃related circulating overload in inpatients and their relationship with clinical outcome

作　　者：赵煜 郝蒙蒙 刘希曦[1] 曹永彤[1] ZHAO Yu;HAO Mengmeng;LIU Xixi;CAO Yongtong(Blood Transfusion Department,Sino-Japanese Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院输血科,北京100029

出　　处：《中国输血杂志》2023年第6期504-507,共4页Chinese Journal of Blood Transfusion

基　　金：中日友好医院院级科研基金资助项目(2019-1-QN-50)。

摘　　要：目的探讨住院患者输血相关循环超负荷(transfusion⁃related circulating overload,TACO)的危险因素,分析其对临床结局的影响。方法回顾性分析选择2020年6月至2022年6月本院收治的295例住院期间输血患者临床资料,根据是否发生TACO将患者分为TACO组(23例)和对照组(272例)。多因素Logistic回归分析影响TACO的危险因素,比较TACO组和对照组住院时间、死亡率的差异。结果295例患者中23例发生TACO,占全部输血反应的7.80%。不同输血成分中TACO发生情况差异具有统计学意义(P<0.05)。年龄较大、既往心力衰竭病史、既往慢性肾病病史、平均输血量大、液体正平衡[OR(95%CI):2.022(1.212~3.372),1.917(1.258~2.922),1.719(1.155~2.560),2.252(1.256~4.039),2.221(1.358~3.633)]是TACO发生的主要危险因素(P<0.05)。结论高龄、既往心力衰竭病史、既往慢性肾病病史、输血量大、液体正平衡等是TACO的危险因素,TACO与住院时间和住院T期间死亡率增加相关。Objective To investigate the risk factors of transfusion⁃related circulating overload(TACO)in hospitalized patients and to analyze its impact on clinical outcome.Methods The clinical data of 295 patients with blood transfusion ad⁃mitted to our hospital from June 2020 to June 2022 were retrospectively analyzed.The patients were divided into TACO group(n=23)and control group(n=272)according to the incidence of TACO.The risk factors of TACO were analyzed by Logis⁃tic regression,and the differences of hospital stay and mortality between the TACO group and the control group were com⁃pared.Results TACO occurred in 23 of 295 patients,accounting for 7.80%of all transfusion reactions.The incidence of TACO in different transfusion components was different.Elder age,history of heart failure,history of chronic kidney disease,large mean blood transfusion volume,positive fluid balance[OR(95%CI):2.022(1.212-3.372),1.917(1.258-2.922),1.719(1.155-2.560),2.252(1.256-4.039),2.221(1.358-3.633)]were the main risk factors for TACO(P<0.05).Conclusion Elder age,history of heart failure,history of chronic kidney disease,large blood transfusion volume and positive fluid balance were risk factors for TACO,and TACO was associ⁃ated with increased length of stay and mortality during hospitalization.

关 键 词：输血相关循环超负荷 心力衰竭 肺水肿 慢性肾病 液体正平衡 危险因素 

分 类 号：R457.1[医药卫生—治疗学]