Purpose: To investigate the impact of minor perioperative bleeding requiring transfusion of 1-2 red blood cell (RBC) units on the outcome after coronary artery bypass grafting (CABG). Methods: Sixteen cardiac surgical centers contributed to the prospective European CABG registry (E-CABG). 1,014 patients receiving 1-2 RBC units during or after isolated CABG were compared to 2,264 patients not receiving RBCs. Results: In 827 propensity score matched pairs, transfusion of 1-2 RBC units did not affect the risk of in-hospital/30-day death (p=0.523) or stroke (p=0.804). However, RBC transfusion was associated with an increased risk of acute kidney injury (p=0.008), sternal wound infection (p=0.001), postoperative use of antibiotics (p=0.001), prolonged use of inotropes (p<0.0001), use of intra-aortic balloon pump (p=0.012), length of intensive care unit stay (p<0.0001) and length of in-hospital stay (p<0.0001). Matched paired analysis excluding pre- and postoperative critical hemodynamic conditions showed that RBC transfusion was associated with an increased risk of major complications except in-hospital/30-day death. Conclusions: Minor perioperative bleeding and subsequent transfusion of 1-2 RBC units did not affect the risk of early death, but increased the risk of other major adverse events. Minimizing perioperative bleeding and prevention of even low-volume RBC transfusion may improve the outcome after CABG.

The Impact of Minor Blood Transfusion on the Outcome after Coronary Artery Bypass Grafting / Kinnunen, Em; Zanobini, M; Onorati, F; Brascia, D; Mariscalco, G; Franzese, I; Ruggieri, Vg; Bounader, K; Perrotti, A; Musumeci, F; Santarpino, G; Maselli, D; Nardella, S; Gulbins, H; Gherli, R; Rubino, As; Mignosa, C; De Feo, M; Gatti, G; Santini, F; Salsano, A; Dalén, M; Saccocci, M; Reichart, D; Faggian, G; Gherli, Tiziano; Nicolini, Francesco; Biancari, F. 4.. - In: JOURNAL OF CRITICAL CARE. - ISSN 0883-9441. - 40(2017), pp. 207-212. [10.1016/j.jcrc.2017.04.025]

The Impact of Minor Blood Transfusion on the Outcome after Coronary Artery Bypass Grafting

GHERLI, Tiziano;NICOLINI, Francesco;
2017

Abstract

Purpose: To investigate the impact of minor perioperative bleeding requiring transfusion of 1-2 red blood cell (RBC) units on the outcome after coronary artery bypass grafting (CABG). Methods: Sixteen cardiac surgical centers contributed to the prospective European CABG registry (E-CABG). 1,014 patients receiving 1-2 RBC units during or after isolated CABG were compared to 2,264 patients not receiving RBCs. Results: In 827 propensity score matched pairs, transfusion of 1-2 RBC units did not affect the risk of in-hospital/30-day death (p=0.523) or stroke (p=0.804). However, RBC transfusion was associated with an increased risk of acute kidney injury (p=0.008), sternal wound infection (p=0.001), postoperative use of antibiotics (p=0.001), prolonged use of inotropes (p<0.0001), use of intra-aortic balloon pump (p=0.012), length of intensive care unit stay (p<0.0001) and length of in-hospital stay (p<0.0001). Matched paired analysis excluding pre- and postoperative critical hemodynamic conditions showed that RBC transfusion was associated with an increased risk of major complications except in-hospital/30-day death. Conclusions: Minor perioperative bleeding and subsequent transfusion of 1-2 RBC units did not affect the risk of early death, but increased the risk of other major adverse events. Minimizing perioperative bleeding and prevention of even low-volume RBC transfusion may improve the outcome after CABG.
The Impact of Minor Blood Transfusion on the Outcome after Coronary Artery Bypass Grafting / Kinnunen, Em; Zanobini, M; Onorati, F; Brascia, D; Mariscalco, G; Franzese, I; Ruggieri, Vg; Bounader, K; Perrotti, A; Musumeci, F; Santarpino, G; Maselli, D; Nardella, S; Gulbins, H; Gherli, R; Rubino, As; Mignosa, C; De Feo, M; Gatti, G; Santini, F; Salsano, A; Dalén, M; Saccocci, M; Reichart, D; Faggian, G; Gherli, Tiziano; Nicolini, Francesco; Biancari, F. 4.. - In: JOURNAL OF CRITICAL CARE. - ISSN 0883-9441. - 40(2017), pp. 207-212. [10.1016/j.jcrc.2017.04.025]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11381/2825304
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