Factors influencing haemostasis and blood transfusion in cardiac surgery.

To find out the risk factors influencing perioperative bleeding and use of blood products in cardiac surgery so that appropriate interventions can be selected for blood conservation, risk factors were analysed in 343 cardiac surgical patients, retrospectively, by multiple regression technique. The results showed that the factors related to postoperative bleeding were male gender, Higgins score, cardiopulmonary bypass (CPB) time, operation procedures, intraoperative blood loss and use of internal mammary artery (IMA) graft. Factors related to perioperative homologous blood transfusions were emergency surgery, preoperative haemoglobin level, Higgins score, intraoperative blood loss, operation time and operation procedures. The geometric mean of postoperative bleeding in the entire series was 1085 ml and the mean packed red cell, plasma and platelet transfusions were 3.29 +/- 0.4, 1.96 +/- 0.39 and 0.21 +/- 0.05 units respectively. The incidence of homologous blood transfusion during the hospital stay was 58.9% for the entire series and 54.5% in the nonrevision patients. Emergency patients received significantly more blood transfusion (p = 0.0001). Perioperative blood loss and transfusions are still problems in cardiac surgery and certain patient groups in this study were identified as high risk; available blood conservation techniques, therefore, are recommended in these patients.