Blood Transfusions: Gender Differences in Utilization, Predictors, and Outcomes

输血：利用、预测因素和结果的性别差异

基本信息

批准号：
7845026
负责人：
MARY A. M. ROGERS
金额：
$ 19.93万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-01 至 2012-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7845026
关键词：
Accident and Emergency department Accounting Age Age-Years Allogenic Ambulatory Care Facilities American Autologous Blood Blood Transfusion Blood typing procedure Body mass index Characteristics Clinical Services Code Cohort Studies Country Data Deep Vein Thrombosis Diabetes Mellitus Disease Elderly Elderly woman Enrollment Ethnic Origin Evaluation Event Fee-for-Service Plans Filtration Gender Health Health Services Hematocrit procedure Hemoglobin Hemorrhage Home visitation Hospitalization Hospitals House Call ICD-9 Immunosuppression Individual Infection Knowledge Laboratories Length Length of Stay Life Link Medical History Medicare Meta-Analysis Myocardial Infarction Operative Surgical Procedures Outcome Outpatients Patients Pattern Physicians Policy Maker Population Procedures Process Provider Publishing Pulmonary Embolism Race Randomized Controlled Trials Reporting Research Rest Retirement Risk Sampling Services Sex Characteristics Skilled Nursing Facilities Smoke Socioeconomic Factors Source Stroke Thrombosis Time Transfusion Transient Ischemic Attack Trauma United States United States Centers for Medicare and Medicaid Services Variant Visit Weight Woman design disability hospice environment human old age (65+)lifestyle factors men population based programs public health relevance sex socioeconomics

项目摘要

DESCRIPTION (provided by applicant): Blood transfusion is the most common ICD-9-coded procedure performed in women during hospitalization in the United States. Transfusions are more frequent in women than men since the criteria for prescribing a transfusion often rests with threshold levels of hematocrit or hemoglobin which are normally lower in women. While transfusions have been considered life- saving in patients with significant blood loss, there is increasing evidence of immunomodulatory effects and thrombosis after transfusion. Unfortunately, there are no population-based reports on the characteristics of people who receive blood transfusions in the United States and little research regarding gender-specific outcomes during the post-transfusion period. A cohort study is proposed to examine the profiles of women and men who receive transfusions and gender- specific post-transfusion outcomes. Subjects will be a representative sample of Americans, ages 65 years and older, who were enrolled in fee-for-service Medicare programs. There are three specific aims: (1) to examine the variability in blood transfusion by subject characteristics, type of provider, and region in a representative sample of elderly Americans; (2) to assess the risk of infection after allogeneic blood transfusion in women and men; and (3) to assess the risk of thrombotic events after allogeneic blood transfusion in women and men. Linked files from the nationally-representative Health and Retirement Study (HRS) and the Medicare data will be used. This will include Center for Medicare and Medicaid Services (CMS) data for hospital stays, physician visits, home health services, skilled nursing facility stays, visits to outpatient clinics and ambulatory surgical centers, emergency department visits, hospice services, and clinical laboratory services from 1991 through 2007. Information regarding blood transfusion, infection, and thrombotic events (deep-vein thrombosis, pulmonary embolism, transient ischemic attack, stroke, and myocardial infarction) will be extracted from CMS files. Data regarding demographic information, lifestyle factors, disabilities, and medical history will be obtained from the HRS. Statistical analyses will involve weighting to account for the sampling design of the HRS and the results will be presented as national estimates of blood utilization for elderly women and men in the United States. Public Health Relevance: This study will provide the public, clinicians, and policy-makers with information regarding blood utilization, predictors of blood transfusion, and outcomes associated with blood transfusion in elderly women and men in the United States.

描述（由申请人提供）：输血是在美国住院期间在妇女中执行的最常见的ICD-9编码程序。女性的输血比男性更频繁，因为开处方输血的标准通常取决于女性通常较低的血细胞比容或血红蛋白的阈值水平。尽管输血被认为是失血率严重的患者的寿命，但越来越多的证据表明，输血后免疫调节作用和血栓形成。不幸的是，没有关于在美国接受输血的人的特征的基于人群的报告，并且在转移后期，关于性别特定结果的研究很少。提出了一项队列研究，以检查接受输血和特定于性别后输血后结果的男女的特征。受试者将是65岁及以上的美国人的代表性样本，他们参加了费用的医疗保险计划。有三个特定的目的：（1）检查代表性的美国人样本中，由主题特征，提供者类型和地区进行输血的变异；（2）评估男女同种异体输血后感染的风险；（3）评估男女同种异体输血后血栓形成事件的风险。将使用来自全国代表性的健康和退休研究（HRS）和Medicare数据的链接文件。这将包括医疗保险和医疗补助服务中心（CMS），用于住院，医师探访，家庭卫生服务，熟练的护理设施，访问访问，访问门诊诊所和门诊手术中心，急诊室就诊，临终关怀服务，临终关怀服务和1991年的临床实验室服务，从1991年到2007年。攻击，中风和心肌梗塞将从CMS文件中提取。有关人口统计信息，生活方式因素，残疾和病史的数据将从HRS获得。统计分析将涉及加权以说明HRS的采样设计，结果将作为美国老年男女血液利用的全国性估计。公共卫生相关性：这项研究将为公众，临床医生和政策制定者提供有关血液利用率，输血的预测因素以及与美国老年男女输血相关的结果。