Predictors of allogenic blood transfusion in elective cardiac surgery after preoperative autologous blood donation

Takami, Yoshiyuki; Masumoto, Hiroshi

doi:10.1007/s00595-008-3893-5

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…The report from the STS Workforce on Evidence Based Surgery indicates that numerous studies have identified prolonged CPB time as a risk factor associated with increased transfusions [2], in line with increased blood cell damage and coagulation disorders due to alteration of the coagulation cascade [25]. Swaminathan and colleagues found an association between lowest hematocrit during CPB and increased transfusion [26], while Takami and Masumoto recently indicated that independent factors for allogeneic blood transfusion included preoperative and minimum hemoglobin values during cardiopulmonary bypass [27]. The association between low preoperative hematocrit and increased transfusion is generally confirmed by several studies [2].…”

Section: Discussionmentioning

confidence: 99%

A simple clinical model for planning transfusion quantities in heart surgery

Simeone

Franchi

Cevenini

et al. 2011

BMC Med Inform Decis Mak

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BackgroundPatients undergoing heart surgery continue to be the largest demand on blood transfusions. The need for transfusion is based on the risk of complications due to poor cell oxygenation, however large transfusions are associated with increased morbidity and risk of mortality in heart surgery patients. The aim of this study was to identify preoperative and intraoperative risk factors for transfusion and create a reliable model for planning transfusion quantities in heart surgery procedures.MethodsWe performed an observational study on 3315 consecutive patients who underwent cardiac surgery between January 2000 and December 2007. To estimate the number of packs of red blood cells (PRBC) transfused during heart surgery, we developed a multivariate regression model with discrete coefficients by selecting dummy variables as regressors in a stepwise manner. Model performance was assessed statistically by splitting cases into training and testing sets of the same size, and clinically by investigating the clinical course details of about one quarter of the patients in whom the difference between model estimates and actual number of PRBC transfused was higher than the root mean squared error.ResultsTen preoperative and intraoperative dichotomous variables were entered in the model. Approximating the regression coefficients to the nearest half unit, each dummy regressor equal to one gave a number of half PRBC. The model assigned 4 units for kidney failure requiring preoperative dialysis, 2.5 units for cardiogenic shock, 2 units for minimum hematocrit at cardiopulmonary bypass less than or equal to 20%, 1.5 units for emergency operation, 1 unit for preoperative hematocrit less than or equal to 40%, cardiopulmonary bypass time greater than 130 minutes and type of surgery different from isolated artery bypass grafting, and 0.5 units for urgent operation, age over 70 years and systemic arterial hypertension.ConclusionsThe regression model proved reliable for quantitative planning of number of PRBC in patients undergoing heart surgery. Besides enabling more rational resource allocation of costly blood-conservation strategies and blood bank resources, the results indicated a strong association between some essential postoperative variables and differences between the model estimate and the actual number of packs transfused.

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Section: Discussionmentioning

confidence: 99%

A simple clinical model for planning transfusion quantities in heart surgery

Simeone

Franchi

Cevenini

et al. 2011

BMC Med Inform Decis Mak

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show abstract

“…11 Another timely report 12 is on the clinical outcome of perioperative nonpermanent vena cava fi lter placement in the treatment of deep venous thrombosis, a condition the seriousness of which has become increasingly apparent. Other reports include risk factor evaluation for the severely ischemic limb and fi ndings from some basic animal experiments, such as anti-inducible costimulator antibody immunotherapy for cardiac allograft rejection 13 and inhibition of intimal hyperplasia.…”

Section: Heart and Vesselsmentioning

confidence: 99%

Current status of and prospects for the English medical journal Surgery Today

Maehara

Kakeji

2010

Surg Today

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“…Screening programmes have substantially reduced the risk for clinically well-known infections such as hepatitis C virus (HCV) and human immunodeficiency virus (HIV), but new viruses with parenteral modes of transmission may create new problems in the future. A benefit of autologous blood predonation (ABP) has been shown for elective coronary artery bypass surgery and cardiac valve operations [8][9][10][11]. Accordingly, we hypothesised that ABP reduces allogeneic transfusion requirement in adults upon re-operation for congenital heart defects.…”

Section: Introductionmentioning

confidence: 96%