Risk factors for postoperative adverse ischemic events in high-altitude patients requiring intraoperative erythrocyte transfusion
10.3760/cma.j.cn131073-20241024-00608
- VernacularTitle:术中红细胞输注高原患者术后缺血不良事件的危险因素
- Author:
Huanzhen LUO
1
;
Kaixi SHANG
;
Zeng HE
;
Ping XU
;
Zongjing XIA
Author Information
1. 西藏自治区人民政府驻成都办事处医院(四川大学华西医院西藏成办分院)麻醉科,成都 610041
- Publication Type:Journal Article
- Keywords:
Erythrocyte transfusion;
High altitude;
Ischemia;
Risk factors
- From:
Chinese Journal of Anesthesiology
2025;45(6):709-714
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the risk factors for postoperative adverse ischemic events (IEs) in high-altitude patients requiring intraoperative erythrocyte transfusion.Methods:This was a case-control study. Patient perioperative data and blood transfusion information were obtained through the electronic medical record system, biobank and case follow-up database. Patients with a long history of living at high altitudes who underwent elective tracheal intubation with general anesthesia and received red blood cell transfusion during surgery were selected, and their general characteristics and intraoperative data were collected. Based on the occurrence of ischemic events during postoperative hospitalization, patients were divided into IE group and non-IE group, and the risk factors for IE were identified by multivariate logistic regression analysis (stepwise regression).Results:There were 95 patients in IE group and 232 patients in non-IE group. The results of multivariate logistic regression analysis showed that age ≥65 yr, American Society of Anesthesiologists Physical Status classification Ⅲ, extremely high altitude (≥4 500 m), history of cerebral infarction, high altitude polycythemia, low hemoglobin concentration before blood transfusion, large difference in intraoperative Hb concentrations, massive blood loss and long duration of anesthesia were the risk factors for postoperative IEs in high-altitude patients requiring intraoperative erythrocyte transfusion ( P<0.05). Conclusions:Age≥65 yr, American Society of Anesthesiologists Physical Status classification Ⅲ, extremely high altitude, history of cerebral infarction, high altitude polycythemia, low hemoglobin concentration before blood transfusion, large difference in intraoperative Hb concentrations, massive blood loss and long duration of anesthesia are the risk factors for postoperative IEs in high-altitude patients requiring intraoperative erythrocyte transfusion.