Long-term survival And quality Of life after transfusion-associated pulmonary edema in critically III medical patients

Guangxi Li, Marija Kojicic, Martin K. Reriani, Evans R. Fernández Pérez, Lokendra Thakur, Rahul Kashyap, Camille M. Van Buskirk, Ognjen Gajic

Research output: Contribution to journalArticle

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Abstract

Background: Transfusion-related acute lung injury (TKALI) and transfusion-associated circulatory overload (TACO) commonly complicate transfusion in critically ill patients. Prior outcome studies of TACO and TKALI have focused on short-term morbidity and mortality, but the longterm survival and quality of life (QOL) of these patients remain unknown. Methods: In a nested case-control study, we compared survival and QOL between critically ill medical patients who developed pulmonary edema after transfusion (TKALI or TACO) and medical critically ill transfused controls, matched by age, gender, and admission diagnostic group. QOL in survivors was assessed with a 36-item short form health survey I year after initial hospitalization. Results: Hospital, 1-year, and 2-year mortality among the 74 TRALI cases and 74 matched controls were 43.2% vs 24.3% (P= .020), 63.8% vs 46.4% (P= .037) and 74.3% vs 54.3% (P= .031), whereas among the 51 TACO cases and 51 matched controls these values were 7.8% vs 11.8% (P= .727), 38.0% vs 28.0% (P= .371), and 44.9% vs 38.8% (P= .512). When adjusted for age and baseline severity of illness in a Cox proportional hazard analysis, the development of TKALI remained associated with decreased survival (hazard ratio 1.86; 95% CI, 1.19-2.93; P = .006). Both TRALI (P = .006, P = .03) and TACO (P = .03, P = .049) were associated with prolonged ICU and hospital lengths of stay. Conclusions: In critically ill medical patients, development of TRALI, but not TACO, is independently associated with decreased long-term survival.

Original languageEnglish (US)
Pages (from-to)783-789
Number of pages7
JournalChest
Volume137
Issue number4
DOIs
StatePublished - Apr 1 2010

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Pulmonary Edema
Critical Illness
Quality of Life
Survival
Length of Stay
Mortality
Acute Lung Injury
Health Surveys
Survivors
Case-Control Studies
Hospitalization
Outcome Assessment (Health Care)
Morbidity

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Long-term survival And quality Of life after transfusion-associated pulmonary edema in critically III medical patients. / Li, Guangxi; Kojicic, Marija; Reriani, Martin K.; Fernández Pérez, Evans R.; Thakur, Lokendra; Kashyap, Rahul; Van Buskirk, Camille M.; Gajic, Ognjen.

In: Chest, Vol. 137, No. 4, 01.04.2010, p. 783-789.

Research output: Contribution to journalArticle

Li, G, Kojicic, M, Reriani, MK, Fernández Pérez, ER, Thakur, L, Kashyap, R, Van Buskirk, CM & Gajic, O 2010, 'Long-term survival And quality Of life after transfusion-associated pulmonary edema in critically III medical patients', Chest, vol. 137, no. 4, pp. 783-789. https://doi.org/10.1378/chest.09-0841
Li G, Kojicic M, Reriani MK, Fernández Pérez ER, Thakur L, Kashyap R et al. Long-term survival And quality Of life after transfusion-associated pulmonary edema in critically III medical patients. Chest. 2010 Apr 1;137(4):783-789. https://doi.org/10.1378/chest.09-0841
Li, Guangxi ; Kojicic, Marija ; Reriani, Martin K. ; Fernández Pérez, Evans R. ; Thakur, Lokendra ; Kashyap, Rahul ; Van Buskirk, Camille M. ; Gajic, Ognjen. / Long-term survival And quality Of life after transfusion-associated pulmonary edema in critically III medical patients. In: Chest. 2010 ; Vol. 137, No. 4. pp. 783-789.
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title = "Long-term survival And quality Of life after transfusion-associated pulmonary edema in critically III medical patients",
abstract = "Background: Transfusion-related acute lung injury (TKALI) and transfusion-associated circulatory overload (TACO) commonly complicate transfusion in critically ill patients. Prior outcome studies of TACO and TKALI have focused on short-term morbidity and mortality, but the longterm survival and quality of life (QOL) of these patients remain unknown. Methods: In a nested case-control study, we compared survival and QOL between critically ill medical patients who developed pulmonary edema after transfusion (TKALI or TACO) and medical critically ill transfused controls, matched by age, gender, and admission diagnostic group. QOL in survivors was assessed with a 36-item short form health survey I year after initial hospitalization. Results: Hospital, 1-year, and 2-year mortality among the 74 TRALI cases and 74 matched controls were 43.2{\%} vs 24.3{\%} (P= .020), 63.8{\%} vs 46.4{\%} (P= .037) and 74.3{\%} vs 54.3{\%} (P= .031), whereas among the 51 TACO cases and 51 matched controls these values were 7.8{\%} vs 11.8{\%} (P= .727), 38.0{\%} vs 28.0{\%} (P= .371), and 44.9{\%} vs 38.8{\%} (P= .512). When adjusted for age and baseline severity of illness in a Cox proportional hazard analysis, the development of TKALI remained associated with decreased survival (hazard ratio 1.86; 95{\%} CI, 1.19-2.93; P = .006). Both TRALI (P = .006, P = .03) and TACO (P = .03, P = .049) were associated with prolonged ICU and hospital lengths of stay. Conclusions: In critically ill medical patients, development of TRALI, but not TACO, is independently associated with decreased long-term survival.",
author = "Guangxi Li and Marija Kojicic and Reriani, {Martin K.} and {Fern{\'a}ndez P{\'e}rez}, {Evans R.} and Lokendra Thakur and Rahul Kashyap and {Van Buskirk}, {Camille M.} and Ognjen Gajic",
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T1 - Long-term survival And quality Of life after transfusion-associated pulmonary edema in critically III medical patients

AU - Li, Guangxi

AU - Kojicic, Marija

AU - Reriani, Martin K.

AU - Fernández Pérez, Evans R.

AU - Thakur, Lokendra

AU - Kashyap, Rahul

AU - Van Buskirk, Camille M.

AU - Gajic, Ognjen

PY - 2010/4/1

Y1 - 2010/4/1

N2 - Background: Transfusion-related acute lung injury (TKALI) and transfusion-associated circulatory overload (TACO) commonly complicate transfusion in critically ill patients. Prior outcome studies of TACO and TKALI have focused on short-term morbidity and mortality, but the longterm survival and quality of life (QOL) of these patients remain unknown. Methods: In a nested case-control study, we compared survival and QOL between critically ill medical patients who developed pulmonary edema after transfusion (TKALI or TACO) and medical critically ill transfused controls, matched by age, gender, and admission diagnostic group. QOL in survivors was assessed with a 36-item short form health survey I year after initial hospitalization. Results: Hospital, 1-year, and 2-year mortality among the 74 TRALI cases and 74 matched controls were 43.2% vs 24.3% (P= .020), 63.8% vs 46.4% (P= .037) and 74.3% vs 54.3% (P= .031), whereas among the 51 TACO cases and 51 matched controls these values were 7.8% vs 11.8% (P= .727), 38.0% vs 28.0% (P= .371), and 44.9% vs 38.8% (P= .512). When adjusted for age and baseline severity of illness in a Cox proportional hazard analysis, the development of TKALI remained associated with decreased survival (hazard ratio 1.86; 95% CI, 1.19-2.93; P = .006). Both TRALI (P = .006, P = .03) and TACO (P = .03, P = .049) were associated with prolonged ICU and hospital lengths of stay. Conclusions: In critically ill medical patients, development of TRALI, but not TACO, is independently associated with decreased long-term survival.

AB - Background: Transfusion-related acute lung injury (TKALI) and transfusion-associated circulatory overload (TACO) commonly complicate transfusion in critically ill patients. Prior outcome studies of TACO and TKALI have focused on short-term morbidity and mortality, but the longterm survival and quality of life (QOL) of these patients remain unknown. Methods: In a nested case-control study, we compared survival and QOL between critically ill medical patients who developed pulmonary edema after transfusion (TKALI or TACO) and medical critically ill transfused controls, matched by age, gender, and admission diagnostic group. QOL in survivors was assessed with a 36-item short form health survey I year after initial hospitalization. Results: Hospital, 1-year, and 2-year mortality among the 74 TRALI cases and 74 matched controls were 43.2% vs 24.3% (P= .020), 63.8% vs 46.4% (P= .037) and 74.3% vs 54.3% (P= .031), whereas among the 51 TACO cases and 51 matched controls these values were 7.8% vs 11.8% (P= .727), 38.0% vs 28.0% (P= .371), and 44.9% vs 38.8% (P= .512). When adjusted for age and baseline severity of illness in a Cox proportional hazard analysis, the development of TKALI remained associated with decreased survival (hazard ratio 1.86; 95% CI, 1.19-2.93; P = .006). Both TRALI (P = .006, P = .03) and TACO (P = .03, P = .049) were associated with prolonged ICU and hospital lengths of stay. Conclusions: In critically ill medical patients, development of TRALI, but not TACO, is independently associated with decreased long-term survival.

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