Red blood cell transfusions and the risk of acute respiratory distress syndrome among the critically ill: a cohort study

Table 2 Multivariate analysis of independent risk factors for acute respiratory distress syndrome

Variable	Adjusted odds ratio^a,b	95% confidence limits	P value
Age of patient: ≥ 65 years old (reference: < 65 years old)	0.687	0.495–0.954	0.025
Admitting diagnosis (reference: no)
Pneumonia	2.831	1.914–4.186	< 0.0001
Sepsis/Systemic inflammatory response syndrome	0.856	0.552–1.327	0.4875
Trauma	0.974	0.601–1.577	0.9133
ICU type
Surgical ICU (reference: medical ICU and combined)	1.543	1.055–2.259	0.0255
Severity of illness
SOFA score indicator (continuous variable)	1.078	1.034–1.124	0.0005
Process of care (reference: no)
H₂ antagonists at baseline	1.332	0.953–1.862	0.0931
Continuous sedation	4.237	3.000–5.983	< 0.0001
Nutritional status at baseline or ICU day 3–4 (reference: no)
Total parental nutrition	4.659	3.064–7.082	< 0.0001
Enteral nutrition	3.153	2.189–4.540	< 0.0001
Laboratory data at baseline
Albumin ≤ 2.3 mg/dl (reference: no)	1.930	1.390–2.680	< 0.0001
Hemoglobin level (continuous variable)	1.075	1.002–1.152	0.0435
Transfusion status
Any transfusion (yes/no)	2.797	1.899–4.120	< 0.0001
Transfusion exposure (reference: no transfusion)^c
1–2 units transfused	2.191	1.409–3.407	0.0005
> 2 units transfused	3.784	2.417–5.924	< 0.0001

^aAll odds ratios were adjusted for duration of observation and other covariates. ^bOther covariates not achieving the statistical significance entry criterion (p < 0.1) were gender; admitting diagnoses of neurological disorder, gastrointestinal disease, and chronic obstructive pulmonary disease; medical history of diabetes and malignancy; baseline APACHE II (Acute Physiology and Chronic Health Evaluation II) score; antibiotics use at baseline; total serum bilirubin of more than 2.0 mg/dl; and serum creatinine of more than 2.0 mg/dl. ^cEstimated from a separate model in which the categorical transfusion variables replace the transfusion dichotomous variable. ICU, intensive care unit; SOFA, Sequential Organ Failure Assessment.

ISSN: 1364-8535