title: Long-term survival in the intensive care unit after erythrocyte blood transfusion.
abstract: BACKGROUND
  Erythrocyte blood transfusions are commonly used in intensive care units, yet little is known about their effects on long-term survival.
  
  
  OBJECTIVE
  To determine the effect of erythrocyte blood transfusion in intensive care units on long-term survival.
  
  
  METHODS
  Retrospective analysis of a prospectively collected database of 2213 patients admitted January 27, 2001, to April 30, 2002, to the cardiac, burn, neurological-neurosurgical, and combined medical-surgical intensive care units in a tertiary care, university-affiliated, urban medical center. Further analysis was done on a case-control subgroup (n=556) formed by matching scores on the Acute Physiology and Chronic Health Evaluation (APACHE) II and propensity scores.
  
  
  RESULTS
  Although transfusion was univariably associated with increased risk of death at all 3 times (0-30, 31-180, and >180 days after admission to the unit), multivariable adjustment with Cox modeling showed that transfusion had no association with mortality for the first 2 intervals (0-30 and 31-180 days), but was associated with a 25% lower risk of death (hazard ratio, 0.75; 95% confidence interval, 0.57-0.99; P=.04) in patients who survived at least 180 days after admission to the unit. In the case-control patients, after correction for APACHE II risk of death and propensity to receive a transfusion, transfusion had no association with mortality for the first 2 intervals, but was associated with 29% lowered risk of death (hazard ratio, 0.71; 95% confidence interval, 0.50-0.99; P=.046).
  
  
  CONCLUSIONS
  Blood transfusion was associated with a decreased risk of late (>180 days) death in intensive care patients.
authors.affiliation: Department of Anesthesiology, St Vincent Mercy Medical Center, University of Toledo Health Sciences College, Toledo, Ohio 43608, USA. engoren@pol.net
authors.forename: Milo
authors.initials: M
authors.lastname: Engoren
authors.forename: Cynthia
authors.initials: C
authors.lastname: Arslanian-Engoren
mesh_terms: D017707:Erythrocyte Transfusion / Q000401:mortality* / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis