Authors: Santiago R LealNoval Ángela MuñozSerrano Victoria ArellanoOrden Aurelio Cayuela Manuel MuñozGómez Antonio Recio Antonio Alcántara Rosario AmayaVillar Manuel CasadoMéndez Francisco MurilloCabezas
Publish Date: 2015/12/01
Volume: 24, Issue: 3, Pages: 371-380
Abstract
This 3year prospective study examined the association between red blood cell transfusion RBCT and 1year neurocognitive and disability levels in 309 patients with traumatic brain injury TBI admitted to the neurological intensive care unit NICUUsing a telephone interviewbased survey functional outcomes were assessed by the Glasgow Outcome Scale GOS Rancho Los Amigos Levels of Cognitive Functioning Scale RLCFS and Disability Rating Scale DRS and dichotomized as favorable and unfavorable dependent variable The adjusted influence of RBCT on unfavorable results was assessed by conventional logistic regression controlling for illness severity and propensity score introduced as a continuous variable and by propensity scorematched patientsOverall 164 53 patients received ≥1 unit of RBCT during their NICU stay One year postinjury transfused patients exhibited significantly higher unfavorable GOS 460 vs 220 RLCFS 374 vs 154 and DRS 396 vs 187 scores than nontransfused patients Although transfused patients were more severely ill upon admission their adjusted odds ratios 95 confidence intervals for unfavorable GOS RLCFS and DRS scores were 25 12–51 30 14–63 and 23 11–48 respectively These odds ratios remained largely unmodified when the calculated propensity score was incorporated as an independent continuous variable into the multivariate analysis Furthermore in 76 pairs of propensity scorematched patients the rate of an unfavorable RLCFS score at the 1year but not 6month followup was significantly higher in transfused than nontransfused patients 30 11–82
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