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Effect of Red Blood Cell Transfusion on Unfavorable Neurologic Outcome and Symptomatic Vasospasm in Patients with Cerebral Aneurysmal Rupture: Old versus Fresh Blood.

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Author(s)
Eugene KimHyun-Chang KimSang-Youn ParkYoung-Jin LimSoo-Han RoWon-Sang ChoYoung-Tae JeonJung-Won HwangHee-Pyoung Park
Keimyung Author(s)
Kim, Hyun Chang
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Journal Title
World Neurosurgery
Issued Date
2015
Volume
84
Issue
6
Keyword
Blood transfusionCerebral vasospasmNeurologic outcomeStorage duration
Abstract
Background:

Red blood cell (RBC) transfusion, especially with “old” blood, is associated with adverse clinical outcomes. We compared the effects of fresh blood versus old blood transfusion on poor neurologic outcomes and symptomatic vasospasm in patients with ruptured cerebral aneurysms.


Methods:

In this retrospective study, 211 patients with aneurysmal rupture were divided into 3 groups: nontransfusion (n = 136), fresh blood (RBC storage ≤14 days) transfusion (n = 39), and old blood (RBC storage >14 days) transfusion (n = 36). Unfavorable neurologic outcomes (modified Rankin Scale score ≥3) and symptomatic cerebral vasospasm were assessed.


Results:

The incidence of unfavorable neurologic outcomes was significantly higher in the fresh blood and old blood transfusion groups compared with the nontransfused group (71.8% and 58.3% vs. 21.3%; P < 0.01); the incidence of symptomatic vasospasm was significantly higher in the old blood group compared with the fresh blood and nontransfusion groups (57.1% vs. 26.7% and 22.2%; P < 0.05). On binary logistic regression, old age, Hunt and Hess grade 3–4, high postoperative C-reactive protein level, RBC transfusion, delayed infarction, and hydrocephalus were independent predictors of unfavorable neurologic outcomes. Young age, Fisher grade 3–4, old RBC transfusion, and surgical clipping were independent predictors of postoperative symptomatic vasospasm.


Conclusions:

RBC transfusion itself, regardless of the duration of RBC storage, was associated with unfavorable neurologic outcomes in patients with ruptured cerebral aneurysms. Also, old blood transfusion, but not fresh blood transfusion, was associated with increased symptomatic cerebral vasospasm.
Keimyung Author(s)(Kor)
김현창
Publisher
School of Medicine
Citation
Eugene Kim et al. (2015). Effect of Red Blood Cell Transfusion on Unfavorable Neurologic Outcome and Symptomatic Vasospasm in Patients with Cerebral Aneurysmal Rupture: Old versus Fresh Blood. World Neurosurgery, 84(6), 1877–1886. doi: 10.1016/j.wneu.2015.08.024
Type
Article
ISSN
1878-8750
Source
https://www.sciencedirect.com/science/article/pii/S1878875015010396?via%3Dihub
DOI
10.1016/j.wneu.2015.08.024
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32956
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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