Survival and length of stay following blood transfusion in octogenarians following cardiac surgery

Abstract

SummaryOur aim was to assess if peri-operative blood transfusion is an independent risk factor for mortality and morbidity in the elderly. We report the results of a cohort study of all patients aged 80 or more on the day of their emergency or elective cardiac surgery (n = 874), using routinely collected data from January 2003 to November 2007. The primary outcome was all-cause mortality in hospital. The secondary outcomes were duration of stay in the intensive care unit (ICU) and overall hospital stay. Confounding variables were used to build up a risk model using a multivariable logistic regression analysis, and blood transfusion was added to assess whether it had additional predictive value for hospital mortality. Patients were divided into three groups: (i) transfusion of 0-2 units of red blood cells; (ii) transfusion of > 2 units of red blood cells and (iii) transfusion of red blood cells plus other clotting products. The strongest independent predictors of hospital death were logistic EuroSCORE and body mass index. After inclusion of these two variables, the odds ratio for transfusion remained significant. Relative to 0-2 units, the odds ratio for > 2 units was 6.80 (95% CI 2.46-18.8), and for other additional blood products was 14.4 (95% CI 5.34-37.

Age and blood transfusion: relationship and prognostic implications in cardiac surgery

“…Increased experience in patient selection, surgical skill, and perioperative management along with the peculiar setting, i.e., a non-teaching, private practice may explain these results. Data on the interaction between transfusion and age are rare and contradictory (8)(9)(10). The present series revealed that, even though a significantly higher amount of transfusion is needed in elderly patients undergoing cardiac surgical procedures, age per se proved not to be a determinant of the need for RBC.…”

“…Moreover, a growing body of evidence indicates that anaemic patients are more susceptible to transfusionrelated AKI than non-anaemic patients (7). Nevertheless, data about the outcomes of transfusion in elderly patients are scarce and contradictory (8)(9)(10). There is scant evidence that RBC need is higher in this patients' subset.…”

Preoperative Anemia Increases Postoperative Complications and Mortality Following Total Joint Arthroplasty

“…Patients with preoperative anemia are more likely to require postoperative allogeneic transfusion, which was the case in this study. There are a number of studies demonstrating a direct link between allogeneic transfusion and higher complications and even mortality [15][16][17]. Allogeneic transfusion through the process of immunomodulation results in obtunding the immune system of the host which can then result in a higher incidence of infections and other complications.…”

O impacto da hemotransfusão na morbimortalidade pós-operatória de cirurgias cardíacas

“…By analyzing the relationship between blood transfusion and cardiac surgery in an older population, Veenith et al [25] showed that blood transfusion is associated with a significant increase in mortality and length of hospital stay. The authors also report that this possible association is a result of the poor health status of patients in the preoperative period.…”