Association of anaemia, co-morbidities and red blood cell transfusion according to age groups: multicentre sub-analysis of the German Patient Blood Management Network Registry
Authors: Blum Lea Valeska , Schmitt Elke , Choorapoikayil Suma , Baumhove Olaf , Bayer Alexandra , Friederich Patrick , Friedrich Jens , Geisen Christof , Gruenewald Matthias , Gutjahr Martin , Herrmann Eva , Müller Markus , Narita Diana , Raadts Ansgar , Schwendner Klaus , Seifried Erhard , Stark Patrick , Thoma Josef , Weigt Henry , Wiesenack Christoph , Steinbicker Andrea Ulrike , Zacharowski Kai , Meybohm Patrick ,   German PBM Network Collaborators, Baumhove O , de Leeuw van Weenen S , Narita D , Huber J M , Adam E , Choorapoikayil S , Hof L , Isik S , Krämer M , Neb H , Neef V , Piekarski F , Schmitt E , Zacharowski K , Walther T , Holubec T , Schnitzbauer A , Bechstein W O , Derwich W , Schmitz-Rixen T , Steffen B , Serve H , Bojunga J , Zeuzem S , Konczalla J , Seifert V , Roos F , Chun F , Nau C , Marzi I , Leinung M , Stöver T , Ghanaati S , Sader R , Louwen F , Becker S , Ernst J , Sauter Joachim , Wiesenack C , Gerber M , Bayer A , Weigt H , Raadts A , Duemmler J , Gruenewald M , Hummitzsch Lars , Lorenzen U , Renner J , Sokirjanski M , Steinfath M , Pagel M , Haneya A , Puehler T , Berndt R , Rusch R , Becker T , Pochhammer J , Klueter T , Seekamp A , Ahmeti H , Helmers A , Osmonow Daniar , Bauerschlag Dirk , Wieker Henning , Hoffmann Markus , Friedrich J , Molter Gerd , Bier M , Gutjahr M , Bauer R , Bräutigam B , Friederich P , Van Aken H K , Boanta A , Becker J , Bomert M , Bueckmann A , Boerner K , Ceanga A , Cortés M Nunez , Duran I , Fraune T , Gallaby R , Goncalves D , Heßler Ml , Hawari M , Jenke D J , Kieserling K , Korhonen J , Krycki J , Lehmann F , Maeßen T , Mocanu V , Naber Pk , Opas Sn , Peters F , Rauer M , Rieder H , Van Ohlen R , Schilling B , Scholle D , Schulz J , Schwellenbach D , Steinbicker A U , Thoene I , Ueding A , Varelas G , Warnken L , Wempe C , Wisudanto I , Zarbock A , Zurheiden N , Stummer W , Brokinkel B , Martens S , Senniger N , Wolters H , Pascher A , Gosheger G , Moellenbeck B , Deventer N , Oberhuber A , Kasprzak B , Herrmann E , Schrader A , Kiesel L , Kleinheinz J , Koesters C , Raschke M J , Latal T , Niehoff D , Geissler R G , Hillmann H , Stelljes M , Kerkhoff A , Berdel W , Lenz G , Schwendner K , Thoma J , Helmer P , Hottenrott S , Kranke P , Meybohm P , Roeder D , Schlesinger T , Sitter M , Stumpner J , Stark P 
Published: November 2022

Abstract

Background
Blood transfusions are common medical procedures and every age group requires detailed insights and treatment bundles. The aim of this study was to examine the association of anaemia, co-morbidities, complications, in-hospital mortality, and transfusion according to age groups to identify patient groups who are particularly at risk when undergoing surgery.

Methods
Data from 21 Hospitals of the Patient Blood Management Network Registry were analysed. Patients were divided into age subgroups. The incidence of preoperative anaemia, co-morbidities, surgical disciplines, hospital length of stay, complications, in-hospital mortality rate, and transfusions were analysed by descriptive and multivariate regression analysis.

Results
A total of 1 117 919 patients aged 18–108 years were included. With increasing age, the number of co-morbidities and incidence of preoperative anaemia increased. Complications, hospital length of stay, and in-hospital mortality increased with age and were higher in patients with preoperative anaemia. The mean number of transfused red blood cells (RBCs) peaked, whereas the transfusion rate increased continuously. Multivariate regression analysis showed that increasing age, co-morbidities, and preoperative anaemia were independent risk factors for complications, longer hospital length of stay, in-hospital mortality, and the need for RBC transfusion.

Conclusion
Increasing age, co-morbidities, and preoperative anaemia are independent risk factors for complications, longer hospital length of stay, in-hospital mortality, and the need for RBC transfusion. Anaemia diagnosis and treatment should be established in all patients.