Adverse Outcomes of Perioperative Red Blood Cell Transfusions in Coronary Artery Bypass Grafting in Hospital Universiti Sains Malaysia

Abstract

Background Perioperative red blood cell (RBC) transfusion in coronary artery bypass grafting (CABG) has both benefits and harms. Our aim was to study the association between perioperative RBC transfusion and its adverse outcomes. Methods This was a retrospective study of patients who underwent isolated CABG in Hospital Universiti Sains Malaysia, Kelantan, Malaysia, from 1 January 2013 until 31 December 2017. Data were collected from medical records, and comparisons were made between patients who received perioperative RBC transfusions and those who did not have adverse outcomes after CABG. Results A total of 108 patients who underwent isolated CABG were included in our study, and 78 patients received perioperative RBC transfusions. Patients who received perioperative RBC transfusions compared to those who did not were significantly more likely to develop prolonged ventilatory support (21.8% versus 0%, P = 0.003), cardiac morbidity (14.1% versus 0%, P = 0.032), renal morbidity (28.2% versus 3.3%, P = 0.005) and serious infection (20.5% versus 3.3%, P = 0.037). With each unit of packed RBC transfusions, there was a significantly increased risk of prolonged ventilatory support (adjusted odds ratio [AOR] = 1.45; 95% confidence interval [CI] = 1.20–1.77; P < 0.001), cardiac morbidity (AOR =1.40; 95%CI = 1.01–1.79; P = 0.007), renal morbidity (AOR = 1.23; 95%CI = 1.03–1.45; P = 0.019) and serious infection (AOR = 1.31; 95%CI = 1.07–1.60; P = 0.009). Conclusion Perioperative RBC transfusion in isolated CABG patients is associated with increased risks of developing adverse events such as prolonged ventilatory support, cardiac morbidity, renal morbidity and serious infection.

Bleeding risk stratification in coronary artery surgery: the should-not-bleed score

“…Hua Chan et al provided similar findings in their recent study [5]. In their study, perioperative RBC transfusion in isolated CABG patients was associated with increased risks of developing adverse events such as prolonged ventilatory support, cardiac morbidity, renal morbidity and serious infection [5]. It is not just RBC transfusion per se that carries a significant risk for morbidity and mortality in CABG patients.…”

“…4 Department for Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia. 5 Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia. 6 Accounting Department, University of Zagreb Faculty of Economics and Business, Zagreb, Croatia.…”