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Blood Transfusion and Increased Perioperative Risk in Coronary Artery Bypass Grafts

OBJECTIVE: To correlate blood transfusions and clinical outcomes during hospitalization in coronary artery bypass grafting surgery (CABG). METHODS: Transfusion, clinical and hematological data were collected for 1,378 patients undergoing isolated or combined CABG between January 2011 and December 20...

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Autores principales: Campos, Igor C., Tanganelli, Valessa, Maues, Hugo P., Coelho, Marcio C. M., Martins, Fernanda A., Munhoz, Giovana, Egito, Julyana G. T., Souza, Hayala C. C., Giannini, Cássio M. C., Farsky, Pedro S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cirurgia Cardiovascular 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701093/
https://www.ncbi.nlm.nih.gov/pubmed/29211220
http://dx.doi.org/10.21470/1678-9741-2017-0034
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author Campos, Igor C.
Tanganelli, Valessa
Maues, Hugo P.
Coelho, Marcio C. M.
Martins, Fernanda A.
Munhoz, Giovana
Egito, Julyana G. T.
Souza, Hayala C. C.
Giannini, Cássio M. C.
Farsky, Pedro S.
author_facet Campos, Igor C.
Tanganelli, Valessa
Maues, Hugo P.
Coelho, Marcio C. M.
Martins, Fernanda A.
Munhoz, Giovana
Egito, Julyana G. T.
Souza, Hayala C. C.
Giannini, Cássio M. C.
Farsky, Pedro S.
author_sort Campos, Igor C.
collection PubMed
description OBJECTIVE: To correlate blood transfusions and clinical outcomes during hospitalization in coronary artery bypass grafting surgery (CABG). METHODS: Transfusion, clinical and hematological data were collected for 1,378 patients undergoing isolated or combined CABG between January 2011 and December 2012. The effect of blood transfusions was evaluated through multivariate analysis to predict three co-primary outcomes: composite ischemic events, composite infectious complications and hospital mortality. Because higher risk patients receive more transfusions, the hospital mortality outcome was also tested on a stratum of low-risk patients to isolate the effect of preoperative risk on the results. RESULTS: The transfusion rate was 63.9%. The use of blood products was associated with a higher incidence of the three coprimary outcomes: composite infectious complications (OR 2.67, 95% CI 1.70 to 4.19; P<0.001), composite ischemic events (OR 2.42, 95% CI 1.70 to 3.46; P<0.001) and hospital mortality (OR 3.07, 95% CI 1.53 to 6.13; P<0.001). When only patients with logistic EuroSCORE ≤ 2% were evaluated, i.e., low-risk individuals, the mortality rate and the incidence of ischemic events and infectious complications composites remained higher among the transfused patients [6% vs. 0.4% (P<0.001), 11.7% vs. 24,3% (P<0.001) and 6.5% vs. 12.7% (P=0.002), respectively]. CONCLUSION: The use of blood components in patients undergoing CABG was associated with ischemic events, infectious complications and hospital mortality, even in low-risk patients.
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spelling pubmed-57010932017-11-28 Blood Transfusion and Increased Perioperative Risk in Coronary Artery Bypass Grafts Campos, Igor C. Tanganelli, Valessa Maues, Hugo P. Coelho, Marcio C. M. Martins, Fernanda A. Munhoz, Giovana Egito, Julyana G. T. Souza, Hayala C. C. Giannini, Cássio M. C. Farsky, Pedro S. Braz J Cardiovasc Surg Original Article OBJECTIVE: To correlate blood transfusions and clinical outcomes during hospitalization in coronary artery bypass grafting surgery (CABG). METHODS: Transfusion, clinical and hematological data were collected for 1,378 patients undergoing isolated or combined CABG between January 2011 and December 2012. The effect of blood transfusions was evaluated through multivariate analysis to predict three co-primary outcomes: composite ischemic events, composite infectious complications and hospital mortality. Because higher risk patients receive more transfusions, the hospital mortality outcome was also tested on a stratum of low-risk patients to isolate the effect of preoperative risk on the results. RESULTS: The transfusion rate was 63.9%. The use of blood products was associated with a higher incidence of the three coprimary outcomes: composite infectious complications (OR 2.67, 95% CI 1.70 to 4.19; P<0.001), composite ischemic events (OR 2.42, 95% CI 1.70 to 3.46; P<0.001) and hospital mortality (OR 3.07, 95% CI 1.53 to 6.13; P<0.001). When only patients with logistic EuroSCORE ≤ 2% were evaluated, i.e., low-risk individuals, the mortality rate and the incidence of ischemic events and infectious complications composites remained higher among the transfused patients [6% vs. 0.4% (P<0.001), 11.7% vs. 24,3% (P<0.001) and 6.5% vs. 12.7% (P=0.002), respectively]. CONCLUSION: The use of blood components in patients undergoing CABG was associated with ischemic events, infectious complications and hospital mortality, even in low-risk patients. Sociedade Brasileira de Cirurgia Cardiovascular 2017 /pmc/articles/PMC5701093/ /pubmed/29211220 http://dx.doi.org/10.21470/1678-9741-2017-0034 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Campos, Igor C.
Tanganelli, Valessa
Maues, Hugo P.
Coelho, Marcio C. M.
Martins, Fernanda A.
Munhoz, Giovana
Egito, Julyana G. T.
Souza, Hayala C. C.
Giannini, Cássio M. C.
Farsky, Pedro S.
Blood Transfusion and Increased Perioperative Risk in Coronary Artery Bypass Grafts
title Blood Transfusion and Increased Perioperative Risk in Coronary Artery Bypass Grafts
title_full Blood Transfusion and Increased Perioperative Risk in Coronary Artery Bypass Grafts
title_fullStr Blood Transfusion and Increased Perioperative Risk in Coronary Artery Bypass Grafts
title_full_unstemmed Blood Transfusion and Increased Perioperative Risk in Coronary Artery Bypass Grafts
title_short Blood Transfusion and Increased Perioperative Risk in Coronary Artery Bypass Grafts
title_sort blood transfusion and increased perioperative risk in coronary artery bypass grafts
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701093/
https://www.ncbi.nlm.nih.gov/pubmed/29211220
http://dx.doi.org/10.21470/1678-9741-2017-0034
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