{"id":"https://openalex.org/W7222996892","doi":"https://doi.org/10.21203/rs.3.rs-11062424/v1","title":"First ICU-day red blood cell transfusion burden and subsequent ICU delirium after cardiac surgery: a 24-h landmark study using MIMIC-IV","display_name":"First ICU-day red blood cell transfusion burden and subsequent ICU delirium after cardiac surgery: a 24-h landmark study using MIMIC-IV","publication_year":2026,"publication_date":"2026-10-20","ids":{"openalex":"https://openalex.org/W7222996892","doi":"https://doi.org/10.21203/rs.3.rs-11062424/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-11062424/v1","doi":"https://doi.org/10.21203/rs.3.rs-11062424/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11062424/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.21203/rs.3.rs-11062424/v1","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5137021541","display_name":"Lezhen Wang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I154099455","display_name":"Shandong University","ror":"https://ror.org/0207yh398","country_code":"CN","type":"education","lineage":["https://openalex.org/I154099455"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Lezhen Wang","raw_affiliation_strings":["Qilu Hospital (Qingdao), Shandong University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Qilu Hospital (Qingdao), Shandong University","institution_ids":["https://openalex.org/I154099455"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5135630209","display_name":"HAN Ying","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210103957","display_name":"Second Hospital of Shandong University","ror":"https://ror.org/01fd86n56","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210103957"]},{"id":"https://openalex.org/I4210161528","display_name":"Qilu Hospital of Shandong University","ror":"https://ror.org/056ef9489","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210161528"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Ying Han","raw_affiliation_strings":["The Second Qilu Hospital of Shandong University, Shandong University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Second Qilu Hospital of Shandong University, Shandong University","institution_ids":["https://openalex.org/I4210103957","https://openalex.org/I4210161528"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5101619873","display_name":"Xiaotian Ma","orcid":"https://orcid.org/0000-0001-6257-696X","observed_orcids":["https://orcid.org/0000-0001-6257-696X"]},"institutions":[{"id":"https://openalex.org/I154099455","display_name":"Shandong University","ror":"https://ror.org/0207yh398","country_code":"CN","type":"education","lineage":["https://openalex.org/I154099455"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xiaotian Ma","raw_affiliation_strings":["Qilu Hospital (Qingdao), Shandong University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Qilu Hospital (Qingdao), Shandong University","institution_ids":["https://openalex.org/I154099455"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159132121","display_name":"Xuanlong Wang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I154099455","display_name":"Shandong University","ror":"https://ror.org/0207yh398","country_code":"CN","type":"education","lineage":["https://openalex.org/I154099455"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xuanlong Wang","raw_affiliation_strings":["Qilu Hospital (Qingdao), Shandong University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Qilu Hospital (Qingdao), Shandong University","institution_ids":["https://openalex.org/I154099455"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5009805365","display_name":"Penghui Wei","orcid":"https://orcid.org/0000-0003-0920-2779","observed_orcids":["https://orcid.org/0000-0003-0920-2779"]},"institutions":[{"id":"https://openalex.org/I154099455","display_name":"Shandong University","ror":"https://ror.org/0207yh398","country_code":"CN","type":"education","lineage":["https://openalex.org/I154099455"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Penghui Wei","raw_affiliation_strings":["Qilu Hospital (Qingdao), Shandong University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Qilu Hospital (Qingdao), Shandong University","institution_ids":["https://openalex.org/I154099455"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5144345395","display_name":"Jie Guo","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210100830","display_name":"Shandong Tumor Hospital","ror":"https://ror.org/01413r497","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210100830"]},{"id":"https://openalex.org/I4210163399","display_name":"Shandong First Medical University","ror":"https://ror.org/05jb9pq57","country_code":"CN","type":"education","lineage":["https://openalex.org/I4210163399"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Jie Guo","raw_affiliation_strings":["Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences","institution_ids":["https://openalex.org/I4210100830","https://openalex.org/I4210163399"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5070932973","display_name":"Guang-Fen Zhang","orcid":"https://orcid.org/0000-0002-3934-8368","observed_orcids":["https://orcid.org/0000-0002-3934-8368"]},"institutions":[{"id":"https://openalex.org/I4210116517","display_name":"Shandong Provincial Hospital","ror":"https://ror.org/02ar2nf05","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210116517"]},{"id":"https://openalex.org/I4210163399","display_name":"Shandong First Medical University","ror":"https://ror.org/05jb9pq57","country_code":"CN","type":"education","lineage":["https://openalex.org/I4210163399"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Guang-fen Zhang","raw_affiliation_strings":["Shandong Provincial Hospital Affiliated to Shandong First Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Shandong Provincial Hospital Affiliated to Shandong First Medical University","institution_ids":["https://openalex.org/I4210116517","https://openalex.org/I4210163399"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5159130510","display_name":"Jianjun Li","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I154099455","display_name":"Shandong University","ror":"https://ror.org/0207yh398","country_code":"CN","type":"education","lineage":["https://openalex.org/I154099455"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Jianjun Li","raw_affiliation_strings":["Qilu Hospital (Qingdao), Shandong University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Qilu Hospital (Qingdao), Shandong University","institution_ids":["https://openalex.org/I154099455"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":6,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10867","display_name":"Intensive Care Unit Cognitive Disorders","score":0.6255000233650208,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10867","display_name":"Intensive Care Unit Cognitive Disorders","score":0.6255000233650208,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10693","display_name":"Blood transfusion and management","score":0.35910001397132874,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11055","display_name":"Cardiac and Coronary Surgery Techniques","score":0.0015999999595806003,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/red-blood-cell-transfusion","display_name":"red blood cell transfusion","score":0.9750000238418579},{"id":"https://openalex.org/keywords/postoperative-delirium","display_name":"postoperative delirium","score":0.9309999942779541},{"id":"https://openalex.org/keywords/cardiac-surgery","display_name":"cardiac surgery","score":0.8669999837875366},{"id":"https://openalex.org/keywords/intensive-care-unit","display_name":"intensive care unit","score":0.9279999732971191},{"id":"https://openalex.org/keywords/early-postoperative-period","display_name":"early postoperative period","score":0.7369999885559082},{"id":"https://openalex.org/keywords/transfusion-volume","display_name":"transfusion volume","score":0.671999990940094},{"id":"https://openalex.org/keywords/pretransfusion-hemoglobin","display_name":"pretransfusion hemoglobin","score":0.9629999995231628},{"id":"https://openalex.org/keywords/competing-risks","display_name":"competing risks","score":0.40400001406669617}],"concepts":[{"id":"https://openalex.org/C2779753318","wikidata":"https://www.wikidata.org/wiki/Q160796","display_name":"Delirium","level":2,"score":0.9010000228881836},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.888700008392334},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.632099986076355},{"id":"https://openalex.org/C2780014101","wikidata":"https://www.wikidata.org/wiki/Q183605","display_name":"Blood transfusion","level":2,"score":0.5311999917030334},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.5252000093460083},{"id":"https://openalex.org/C2778917026","wikidata":"https://www.wikidata.org/wiki/Q43041","display_name":"Hemoglobin","level":2,"score":0.5095999836921692},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.487199991941452},{"id":"https://openalex.org/C77350462","wikidata":"https://www.wikidata.org/wiki/Q1125472","display_name":"Confounding","level":2,"score":0.4683000147342682},{"id":"https://openalex.org/C143095724","wikidata":"https://www.wikidata.org/wiki/Q515895","display_name":"Odds","level":3,"score":0.4456000030040741},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.4260999858379364},{"id":"https://openalex.org/C2776376669","wikidata":"https://www.wikidata.org/wiki/Q5094647","display_name":"Intensive care unit","level":2,"score":0.35989999771118164},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.3434999883174896},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.33629998564720154},{"id":"https://openalex.org/C2776557347","wikidata":"https://www.wikidata.org/wiki/Q37187","display_name":"Red blood cell","level":2,"score":0.33379998803138733},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.32829999923706055},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.3276999890804291},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.3276999890804291},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3221000134944916},{"id":"https://openalex.org/C2776973423","wikidata":"https://www.wikidata.org/wiki/Q360341","display_name":"Organic mental disorders","level":3,"score":0.31369999051094055},{"id":"https://openalex.org/C2911063046","wikidata":"https://www.wikidata.org/wiki/Q183605","display_name":"Red Blood Cell Transfusion","level":3,"score":0.3084000051021576},{"id":"https://openalex.org/C2780976302","wikidata":"https://www.wikidata.org/wiki/Q4677915","display_name":"Acute chest syndrome","level":4,"score":0.2872999906539917},{"id":"https://openalex.org/C2777208419","wikidata":"https://www.wikidata.org/wiki/Q4347672","display_name":"Red Cell","level":2,"score":0.2732999920845032},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.26409998536109924},{"id":"https://openalex.org/C2778789114","wikidata":"https://www.wikidata.org/wiki/Q235007","display_name":"Cardiac surgery","level":2,"score":0.25760000944137573},{"id":"https://openalex.org/C2987404301","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care","level":2,"score":0.2517000138759613}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-11062424/v1","doi":"https://doi.org/10.21203/rs.3.rs-11062424/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11062424/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-11062424/v1","doi":"https://doi.org/10.21203/rs.3.rs-11062424/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11062424/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":33,"referenced_works":["https://openalex.org/W2036193982","https://openalex.org/W2038981426","https://openalex.org/W2042598353","https://openalex.org/W2049966727","https://openalex.org/W2091716126","https://openalex.org/W2097804942","https://openalex.org/W2110818436","https://openalex.org/W2120156715","https://openalex.org/W2125178621","https://openalex.org/W2138141660","https://openalex.org/W2275737843","https://openalex.org/W2463180942","https://openalex.org/W2492495737","https://openalex.org/W2513835084","https://openalex.org/W2587793535","https://openalex.org/W2611645236","https://openalex.org/W2767380802","https://openalex.org/W2792721781","https://openalex.org/W2804595527","https://openalex.org/W2885896746","https://openalex.org/W2911756515","https://openalex.org/W3177419689","https://openalex.org/W4210922057","https://openalex.org/W4292356862","https://openalex.org/W4313439128","https://openalex.org/W4386019465","https://openalex.org/W4395033980","https://openalex.org/W4396633592","https://openalex.org/W4405646135","https://openalex.org/W4407835493","https://openalex.org/W4415666323","https://openalex.org/W6960102814","https://openalex.org/W7152399264"],"related_works":["https://openalex.org/W4416966982","https://openalex.org/W7152399264","https://openalex.org/W3217699248","https://openalex.org/W2887251199","https://openalex.org/W7133778391","https://openalex.org/W2134788078","https://openalex.org/W2068043152","https://openalex.org/W2513835084","https://openalex.org/W2056357915","https://openalex.org/W2397212734"],"abstract_inverted_index":{"Abstract":[0],"Postoperative":[1],"delirium":[2,40,63,75,95,147],"is":[3,9,19],"common":[4],"after":[5,96,148],"cardiac":[6],"surgery":[7],"and":[8,33,53,81,153],"associated":[10,89,141,180],"with":[11,39,90,103,118,130,142,181],"adverse":[12],"outcomes.":[13],"Red":[14],"blood":[15],"cell":[16],"(RBC)":[17],"transfusion":[18,87,178],"frequently":[20],"administered":[21],"during":[22,64],"the":[23,28,65,106],"early":[24],"postoperative":[25],"period":[26],"in":[27,77,105,137],"setting":[29],"of":[30,79,83,93,145],"anemia,":[31],"bleeding,":[32],"physiological":[34],"instability,":[35],"but":[36],"its":[37],"association":[38,170],"developing":[41],"thereafter":[42],"remains":[43,190],"uncertain.":[44],"We":[45],"conducted":[46],"a":[47,54,168],"retrospective":[48],"cohort":[49],"study":[50],"using":[51],"MIMIC-IV":[52],"24-h":[55],"landmark":[56],"design.":[57],"Among":[58,127],"3,488":[59],"patients":[60,129],"without":[61],"documented":[62],"first":[66],"24":[67],"h,":[68],"916":[69],"received":[70],"RBC":[71,86,138,177],"transfusion.":[72],"Subsequent":[73],"ICU":[74,183],"occurred":[76,117],"11.1%":[78],"transfused":[80,128],"3.4%":[82],"nontransfused":[84],"patients.":[85],"was":[88,140,179],"higher":[91,143],"odds":[92,144],"subsequent":[94,146,182],"adjustment":[97,149],"(aOR":[98,109,122],"2.56,":[99],"95%":[100,111,124,162,173],"CI":[101,112,125,163,174],"1.72\u20133.82),":[102],"attenuation":[104],"extended":[107],"model":[108],"1.74,":[110,172],"1.13\u20132.68).":[113],"The":[114],"largest":[115],"estimate":[116],">":[119],"700":[120],"mL":[121],"3.75,":[123],"2.36\u20135.94).":[126],"pre-transfusion":[131,151],"hemoglobin":[132,152],"available,":[133],"each":[134],"350-mL":[135],"increase":[136],"volume":[139],"for":[150],"baseline":[154],"covariates":[155],"(n":[156],"=":[157],"839;":[158],"adjusted":[159],"OR":[160],"1.24,":[161],"1.12\u20131.37).":[164],"Competing-risk":[165],"analysis":[166],"yielded":[167],"similar":[169],"(sHR":[171],"1.15\u20132.63).":[175],"Early":[176],"delirium,":[184],"although":[185],"residual":[186],"confounding":[187],"by":[188],"indication":[189],"possible.":[191]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-21T00:00:00"}
