Article ; Online: Transfusion in Older Anemic Patients: Should the Troponin Value Be Taken into Account?
The American journal of medicine
2022 Volume 135, Issue 8, Page(s) 1008–1015.e1
Abstract: Background: Anemia is common in older individuals, but it is not known whether the prognostic impact of transfusion differs according to cardiac troponin concentration.: Methods: During this 2-year retrospective study in an acute geriatric unit, 514 ... ...
| Abstract | Background: Anemia is common in older individuals, but it is not known whether the prognostic impact of transfusion differs according to cardiac troponin concentration. Methods: During this 2-year retrospective study in an acute geriatric unit, 514 patients with hemoglobin <10 g/dL and troponin sampling were included. Thirty-day and 1-year mortality were compared according to transfusion status and troponin and hemoglobin levels. Results: Of the 514 anemic patients included (median age 88 years), 157 (31%) had elevated troponin concentrations. These patients were more likely to die at 30 days (49% vs 27%, P < .001) and 1 year (65% vs 51%, P = .004) than patients with normal values. Among patients with elevated troponin concentrations, 30-day mortality tended to be lower in transfused than in not-transfused patients (hazard ratio 0.48; 95% confidence interval, 0.21-1.08; P = .07). This association was not found in patients without troponin elevation (hazard ratio 1.09; 95% CI, 0.61-1.93; P = .8). Transfusion was associated with 30-day survival in patients with hemoglobin ≤8 g/dL. It was also associated with excess 1-year mortality in patients with hemoglobin >8 g/dL. Conclusions: This pilot study suggests that transfusion could be associated with better 30-day outcomes in older anemic patients with anemia-related myocardial injury. Thus, troponin levels could be involved in decision-making relative to transfusion in anemic older patients. Clinical trials are needed to establish the benefit of transfusion in patients with elevated troponins. |
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| MeSH term(s) | Aged ; Aged, 80 and over ; Anemia/complications ; Anemia/therapy ; Hemoglobins ; Humans ; Pilot Projects ; Retrospective Studies ; Troponin | |||||
| Chemical Substances | Hemoglobins ; Troponin | |||||
| Language | English | |||||
| Publishing date | 2022-04-22 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 80015-6 | |||||
| ISSN | 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766 | |||||
| ISSN (online) | 1555-7162 ; 1873-2178 | |||||
| ISSN | 0002-9343 ; 1548-2766 | |||||
| DOI | 10.1016/j.amjmed.2022.03.029 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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