• Karthik Raghunathan, Mandeep Singh, Brian H Nathanson, Elliott Bennett-Guerrero, and Peter K Lindenauer.
• Karthik Raghunathan is an associate professor, Department of Anesthesiology, Duke University Medical Center and Durham Veterans Affairs Medical Center, Durham, North Carolina. Mandeep Singh is an assistant professor, Department of Anesthesiology, University of Southern California, Los Angeles, California. Brian H. Nathanson is chief executive officer, OptiStatim, LLC, Longmeadow, Massachusetts. Elliott Bennett-Guerrero is a professor, Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, New York. Peter K. Lindenauer is director, Institute for Healthcare Delivery and Population Science, and professor of medicine, University of Massachusetts-Baystate; professor of quantitative health sciences, University of Massachusetts Medical School, Worcester; and an adjunct professor, Tufts University School of Medicine, and Tufts Clinical and Translational Science Institute, Boston, Massachusetts. Karthik.Raghunathan@duke.edu.
• Am. J. Crit. Care. 2018 May 1; 27 (3): 205-211.

BackgroundEarly red blood cell transfusions are a common treatment for adults hospitalized for sepsis without shock. However, their utility and association with mortality and costs have not been well studied.ObjectivesTo examine early transfusion rates for patients with sepsis treated outside intensive care units, and to find a correlation between transfusion rates and survival rates and costs.MethodsData were obtained from hospital members of the Premier Healthcare Alliance that admitted at least 50 adults with sepsis between January 1, 2006, and December 31, 2010. Early transfusion rates at each hospital were calculated as the observed incidence of allogeneic red blood cells administered by hospital day 2. A multivariable logistic regression model was constructed to estimate the expected or risk-adjusted transfusion rates, mortality rates, and costs.ResultsA total of 256 396 adults were hospitalized with sepsis without major bleeding or surgery at 364 US hospitals. Approximately 84% of all patients admitted with sepsis, without vasopressor therapy, were treated outside the intensive care unit (by day 2). The mean institutional early transfusion rate was 6.9%. After risk standardization, the median (interquartile range) transfusion rate was 6.7% (5.8%-7.6%), mortality rate was 15.5% (13.1%-18.1%), and costs were $13 333 ($11 939-$14 986). Early transfusion rates were not correlated with mortality but were modestly positively correlated with costs (Spearman ρ = 0.157; P = .003).ConclusionsEarly transfusion rates during hospitalization for sepsis without shock varied widely across the hospitals. Transfusion rates were associated with increased costs but not with mortality rates.© 2018 American Association of Critical-Care Nurses.

20 keywords...

hide…