A prospective, randomized clinical trial of universal WBC reduction
| Autor: | Leslie A. Kalish, Susan F. Assmann, Christopher P. Stowell, Walter H. Dzik, J.K. Anderson, E.M. O'Neill |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Fever Cost-Benefit Analysis Immunology Blood Component Transfusion Subgroup analysis law.invention Patient Admission Randomized controlled trial Patient age law Intensive care Outcome Assessment Health Care Epidemiology Leukocytes Humans Immunology and Allergy Medicine Blood Transfusion Hospital Mortality Prospective Studies Hospital Costs Child Aged Risk Management business.industry Incidence Infant Transfusion Reaction Bacterial Infections Hematology Length of Stay Middle Aged Readmission rate Drug Utilization Anti-Bacterial Agents Clinical trial Child Preschool Female business Complication Boston |
| Zdroj: | Transfusion. 42:1114-1122 |
| ISSN: | 1537-2995 0041-1132 |
| DOI: | 10.1046/j.1537-2995.2002.00182.x |
| Popis: | BACKGROUND : Recipient exposure to allogeneic donor WBCs results in transfusion complications for selected populations of recipients. Whether or not WBC reduction should be universally applied is highly controversial. STUDY DESIGN AND METHODS : In a general hospital, a randomized, controlled clinical trial of conversion to universal WBC reduction was conducted. Patients (11%) with established medical indications for WBC-reduced blood were not eligible. All other patients who required transfusion were assigned at random to receive either unmodified blood components or stored WBC-reduced RBCs and platelets. Analysis for each patient was restricted to the first hospitalization. RESULTS : All eligible patients (n = 2780) were enrolled. Three specified primary outcome measures were not different between the two groups: 1) in-hospital mortality (8.5% control; 9.0% WBC-reduced; OR, 0.94 [95% CI, 0.72-1.22]; p = 0.64); 2) hospital length of stay (LOS) after transfusion (median number of days, 6.4 for control and 6.3 for WBC-reduced; p = 0.21); and 3) total hospital costs (median, $19,500 for control and $19,200 for WBC-reduced, p = 0.24). Secondary outcomes (intensive care LOS, postoperative LOS, antibiotic usage, and readmission rate) were not different between the two groups. Subgroup analysis based on patient age, sex, amount of blood transfused, or category of surgical procedure showed no effect of WBC reduction. Patients who received WBC-reduced blood had a lower incidence of febrile reactions (p = 0.06). CONCLUSION : A beneficial effect of conversion from selective to universal WBC reduction was not demonstrated. |
| Databáze: | OpenAIRE |
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