Revisiting blood transfusion and predictors of outcome in cardiac surgery patients: A concise perspective

• Type of Material: Article
• Authors: Carlos E. Arias-Morales, Ohio State University; Nicoleta Stoicea, Ohio State University; Alicia A. Gonzalez-Zacarias, Ohio State University; Diana Slawski, University of Toledo; Sujatha Bhandary, Emory University; Theodosios Saranteas, University of Athens; Eva Kaminiotis, University of Athens; Thomas J. Papadimos, University of Toledo
• Language: English
• Date: 2017-01-01
• Publisher: F1000Research
• Publication Version: Final Published Version
• Copyright Statement: © 2017 Arias-Morales CE et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.12688/f1000research.10085.1
• Title of Journal or Parent Work: F1000Research
• Volume: 6
• Start Page: 168
• End Page: 168
• Grant/Funding Information: The author(s) declared that no grants were involved in supporting this work.
• Keywords: cardiopulmonary bypass; length of stay; blood transfusion; cardiac surgery; mortality
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

In the United States, cardiac surgery-related blood transfusion rates reached new highs in 2010, with 34% of patients receiving blood products. Patients undergoing both complex (coronary artery bypass grafting [CABG] plus valve repair or replacement) and non-complex (isolated CABG) cardiac surgeries are likely to have comorbidities such as anemia. Furthermore, the majority of patients undergoing isolated CABG have a history of myocardial infarction. These characteristics may increase the risk of complications and blood transfusion requirement. It becomes difficult to demonstrate the association between transfusions and mortality because of the fact that most patients undergoing cardiac surgery are also critically ill. Transfusion rates remain high despite the advances in perioperative blood conservation, such as the intraoperative use of cell saver in cardiac surgery. Some recent prospective studies have suggested that the use of blood products, even in low-risk patients, may adversely affect clinical outcomes. In light of this information, we reviewed the literature to assess the clinical outcomes in terms of 30-day and 1-year morbidity and mortality in transfused patients who underwent uncomplicated CABG surgery.