Literature DB >> 24690337

The impact of blood use on patients undergoing coronary artery bypass surgery: a prospective study.

A Lako, S Bilali, S Memishaj, A Daka, T Dedej, T Nurka, V Bilali, V Gjylameti.   

Abstract

OBJECTIVES: This survey aimed at assessing the incidence of blood use and the impact of cardiopulmonary bypass (CBP), sex, age, number of grafts, combined cardiac interventions, and hematocrit level in patients who undergo coronary artery bypass graft (CABG) surgery. PATIENTS AND METHODS: A prospective study included patients in the department of cardiac surgery at the American Hospital, in Tirana, Albania. We studied 164 consecutive patients who underwent CABG surgery over a 2-year period (2011-2013).
RESULTS: We analyzed 164 patients: 138 men and 26 women. The average age was 61.8 years (range, 34-82 years). Of these, 116 patients (101 men/15 women) and 48 patients (37 men/11 women) were operated on-pump and off-pump, respectively. Packed red blood cells (PRBC) were administered to 79.87% of patients (131/164). In total, 334 units were transfused. The average number of PRBC units per patient was 2.03 ± 1.5 (range, 0-8 units). Blood transfusion was administered to 87.06% and 62.5% of on-pump and off-pump patients, respectively. On-pump and off-pump patients received 2.4 and 1 unit of PRBC, respectively (p < 0.001). Female and male patients received 2.2 and 2 units, respectively (p = 0.1). Patients aged ≥ 62.5 years received 2.3 units on average versus the average of 1.7 units received by patients aged < 62.5 years (p < 0.001). Interventions with 4-6 grafts (79/164) received an average 2.5 units, while those with 1-3 grafts (85/164) received 1.5 units (p < 0.001). Patients requiring other cardiac surgical interventions (35/164) received an average of 2.6 units, while those without other cardiac surgical interventions (129/164) received an average of 1.8 units (p < 0.001). Patients with preoperative hematocrit < 35% received an average 1.2 units of PRBC intraoperatively, and 2.8 units throughout the hospital stay, while patients with preoperative hematocrit ≥ 35% received an average of 0.75 units intraoperatively (p < 0.001) and 1.9 units throughout the hospital stay (p < 0.001).
CONCLUSION: Blood transfusion was required for 79.87% of patients. Five variables were important factors in the use of blood in patients undergoing CABG: using CBP, a higher number of grafts, age ≥ 62.5 years, combined heart interventions and preoperative hematocrit< 35%. Female patients required more PRBC than male patients, although it was not statistically significant. Knowledge of these risk factors enables better prediction of the probability of patients who might require more blood, better distribution of blood in CABG procedures, use by the blood bank, and evaluation of cost-effectiveness in the use of blood products.

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Year:  2014        PMID: 24690337      PMCID: PMC4321579     

Source DB:  PubMed          Journal:  G Chir        ISSN: 0391-9005


  24 in total

1.  Blood product use in cardiac revascularization: comparison of on- and off-pump techniques.

Authors:  N D Nader; W Z Khadra; N T Reich; D R Bacon; T A Salerno; A L Panos
Journal:  Ann Thorac Surg       Date:  1999-11       Impact factor: 4.330

2.  Why is it important to reduce the need for blood transfusion, and how can it be done?

Authors:  Abi Berger
Journal:  BMJ       Date:  2002-06-01

3.  A provincial program of blood conservation: The Ontario Transfusion Coordinators (ONTraC).

Authors:  J Freedman; K Luke; N Monga; S Lincoln; R Koen; M Escobar; J Chiavetta
Journal:  Transfus Apher Sci       Date:  2005-10-04       Impact factor: 1.764

4.  Effect of blood transfusion on long-term survival after cardiac operation.

Authors:  Milo C Engoren; Robert H Habib; Anoar Zacharias; Thomas A Schwann; Christopher J Riordan; Samuel J Durham
Journal:  Ann Thorac Surg       Date:  2002-10       Impact factor: 4.330

5.  Factors affecting transfusion of fresh frozen plasma, platelets, and red blood cells during elective coronary artery bypass graft surgery.

Authors:  Randal Covin; Maureen O'Brien; Gary Grunwald; Bradley Brimhall; Gulshan Sethi; Steven Walczak; William Reiquam; Chitra Rajagopalan; A Laurie Shroyer
Journal:  Arch Pathol Lab Med       Date:  2003-04       Impact factor: 5.534

6.  Predicting blood transfusion factors in coronary artery bypass surgery.

Authors:  Y Isomatsu; H Tsukui; S Hoshino; Y Nishiya
Journal:  Jpn J Thorac Cardiovasc Surg       Date:  2001-07

7.  Predictors of homologous blood transfusion for patients undergoing open heart surgery.

Authors:  J Litmathe; U Boeken; P Feindt; E Gams
Journal:  Thorac Cardiovasc Surg       Date:  2003-02       Impact factor: 1.827

8.  A multivariable model for predicting the need for blood transfusion in patients undergoing first-time elective coronary bypass graft surgery.

Authors:  K Karkouti; M M Cohen; S A McCluskey; G D Sher
Journal:  Transfusion       Date:  2001-10       Impact factor: 3.157

9.  Does gender influence resource utilization in patients undergoing off-pump coronary artery bypass surgery?

Authors:  Bharathi H Scott; Frank C Seifert; Peter S A Glass
Journal:  J Cardiothorac Vasc Anesth       Date:  2003-06       Impact factor: 2.628

10.  Impact of allogenic packed red blood cell transfusion on nosocomial infection rates in the critically ill patient.

Authors:  Robert W Taylor; Lisa Manganaro; Jacklyn O'Brien; Steven J Trottier; Nadeem Parkar; Christopher Veremakis
Journal:  Crit Care Med       Date:  2002-10       Impact factor: 7.598

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  2 in total

Review 1.  Revisiting blood transfusion and predictors of outcome in cardiac surgery patients: a concise perspective.

Authors:  Carlos E Arias-Morales; Nicoleta Stoicea; Alicia A Gonzalez-Zacarias; Diana Slawski; Sujatha P Bhandary; Theodosios Saranteas; Eva Kaminiotis; Thomas J Papadimos
Journal:  F1000Res       Date:  2017-02-20

2.  Frequency of Blood Transfusion in Elective Coronary Artery Bypass Grafting and Its Correlation With Acute Kidney Injury at a Tertiary Care Hospital in a Lower Middle-Income Country.

Authors:  Muhammad Suleman; Khalid Samad; Hameed Ullah
Journal:  Cureus       Date:  2021-05-22
  2 in total

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