A multivariate analysis to assess the effect of packed red cell transfusion and the unit age of transfused red cells on postoperative complications in patients undergoing cardiac surgeries

Abstract

Background:Transfusion of blood components and age of transfused packed red cells (PRCs) are independent risk factors for morbidity and mortality in cardiac surgeries.Materials and Methods:We retrospectively examined data of patients undergoing cardiac surgery at our institute from January 1, 2012 to September 30, 2012. Details of transfusion (autologous and allogenic), postoperative length of stay (PLOS), postoperative complications were recorded along with other relevant details. The analysis was done in two stages, in the first both transfused and nontransfused individuals and in the second only transfused individuals were considered. Age of transfused red cells as a cause of morbidity was analyzed only in the second stage.Results:Of the 762 patients included in the study, 613 (80.4%) were males and 149 (19.6%) were females. Multivariate analysis revealed that factors like the number and age of transfused PRCs and age of the patient had significant bearing upon the morbidity. Morbidity was significantly higher in the patients transfused with allogenic PRCs when compared with the patients not receiving any transfusion irrespective of the age of transfused PRCs. Transfusion of PRC of over 21 days was associated with higher postoperative complications, but not with in-hospital mortality.Conclusion:In patients undergoing cardiac surgery, allogenic blood transfusion increases morbidity. The age of PRCs transfused has a significant bearing on morbidity, but not on in-hospital mortality. Blood transfusion services will therefore have to weigh the risks and benefits of providing blood older than 21 days in cardiac surgeries.

An Analysis of Blood Utilization for Stem Cell Transplant Patients in a Tertiary Care Hospital

“…The controversy of single unit transfusion still exists. Makroo et al and Paone et al have recently published that there is no statistical difference between one unit and two units of PRBCs in relation with acute surgical complications (odds ratio: 1.12, 95% confidence interval) ( 16 , 17 ).…”

Prognostic Value of Procalcitonin for Morbidity and Mortality in Patients after Cardiac Surgery

“…The results of the present study reveal that those receiving over two units of PC during the treatment and surgery had a significantly higher PCT level compared to those receiving smaller PC quantities. The results of several previous studies have demonstrated that the increased PC transfused during surgery is associated with postoperative complications and higher rates of mortality and morbidity after surgery [ 10 – 12 ]. Additionally, some studies have previously shown that the rise in the PCT level among patients undergoing CABG is associated with the increased consequent complications [ 5 , 13 , 14 ].…”