Abstract Details

Title Red Blood Cell Transfusions and Associations with Outcome after Intracerebral Hemorrhage

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) Neurocritical Care Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 004

Objective To investigate the association between red blood cell (RBC) transfusions and intracerebral hemorrhage (ICH) outcomes.

Background

Anemia is known to be associated with worse clinical outcomes after ICH. However, the relationships between RBC transfusion and ICH outcomes are less clear.

Design/Methods

We analyzed ICH patients consecutively admitted to a large, academic, quaternary referral medical center between 2009 and 2018. Patients <18 years old or with secondary etiologies of ICH were excluded. We performed multivariable logistic regression to assess the relationship between RBC transfusion exposure and hospital mortality while adjusting for baseline intergroup differences (RBC vs non-RBC transfusion groups) and disease severity (ICH and APACHE II scores).

Results A total of 552 primary ICH patients were included, and 57 patients (10%) received RBC transfusions during their hospitalization. Patients receiving RBC transfusions had more severe ICH (median [IQR]: 2 [2-3] vs 2 [1-3]) and worse APACHE II scores (median [IQR]: 21 [15-25] vs 14 [9-21]) compared to patients that did not receive an RBC transfusion. While there was higher mortality in ICH patients receiving RBC transfusions (46% vs 28%; unadjusted OR: 2.21; 95% CI: 1.26-3.88), this association was non-significant after adjusting for disease severity (ICH score and APACHE II) (adjusted OR: 1.85; 95% CI: 0.86-3.98).

Conclusions

Although there is a relationship between RBC transfusion exposure and mortality, underlying disease severity appears to play a role in this relationship. Further work is required to elucidate the independent benefits and risks of RBC transfusions themselves on this vulnerable patient population.

Authors/Disclosures
Fernanda Carvalho Poyraz, MD, PhD PRESENTER	Dr. Carvalho Poyraz has nothing to disclose.
Jessica Magid-Bernstein, MD, PhD (Yale School of Medicine)	Dr. Magid-Bernstein has nothing to disclose.
Mitchell S. Elkind, MD, MS, FAAN	Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy.
Sachin Agarwal, MD, MPH (Columbia University Med Center)	Dr. Agarwal has nothing to disclose.
Soojin Park, MD	Dr. Park has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurocritical Care. The institution of Dr. Park has received research support from National Institutes of Health.
Jan Claassen, MD, PhD (Columbia University College of Physicians & Surgeons)	Dr. Claassen has stock in iCE Neurosystems. The institution of Dr. Claassen has received research support from NINDS. The institution of Dr. Claassen has received research support from McDonnel Foundation. Dr. Claassen has received publishing royalties from a publication relating to health care. Dr. Claassen has received publishing royalties from a publication relating to health care.
	No disclosure on file
David J. Roh, MD (Columbia University Medical Center)	Dr. Roh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Portola Pharmaceuticals.
	No disclosure on file

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