BLOOD TRANSFUSION IN CARDIAC SURGERY IS ASSOCIATED WITH WORSE PROGNOSIS
(Abstract release date: 05/19/16)
EHA Library. Garcia Gala J. 06/09/16; 133116; E1567
Jose Maria Garcia Gala
Contributions
Contributions
Abstract
Abstract: E1567
Type: Eposter Presentation
Background
Transfusion has been associated with a worse prognosis in patients undergoing cardiac surgery so restrictive attitude to transfuse had been proposed.
Aims
In order to assess the impact of transfusion in patients undergoing cardiac surgery we reviewed patients admitted to cardiac ICU.
Methods
Data concerning age, sex, reason for ICU admission, type of surgery, transfusion, preoperative haemoglobin, length of stay in the ICU, ICU survival, EUROSCORE prior to surgery and extracorporeal time from patients admitted in cardiac ICU of our hospital between January 2004 and June 2014 were collected. Univariate analysis with different variables and then a logistic regression model was
Results
We analysed data from 4,315 patients (63% male / 37% female) admitted to the unit during this period. Median age of 67.88 years (0-91 years). 93% were postoperative cardiac surgery. The most common reasons for surgery were valvular surgery (34.5%) coronary surgery (28%), coronary and valve surgery (18%). 3282 of patients (76.1%) were transfused. Patients undergoing valvular surgery were most frequently transfused than those who underwent coronary surgery (77% versus 66%). Transfused patients had lower haemoglobin at the time of surgery than those who were transfused (12.7 ± 1.7 versus 14, 51 ± 1.33, p <0.001). Of the total patients analysed, 23.7% had Hb <12 g / dl at the time of surgery. Of these, 97% were transfused compared to 69% who had Hb> 12 g / dl (p <0.001). Patients with Hb level> 12 g / dl had a survival of 95% versus 88% in the group with Hb <12 g / dl (p <0.001). 97% of non-transfused patients survive versus 88% of transfused patients (p <0.001) with a relative risk of survival of 3.87 (95% CI 2.67-5,99) within the group without transfusion.For most common types of surgery
Patients who were transfused had a shorter average length of stay in the ICU than those who were not (8.46 ± 3.95 days versus 15 ± 3.4, p <0.001)In the logistic regression analysis, the only variable that showed significant for survival was transfusion.
Conclusion
Transfusion is associated with a negative effect on the survival of patients undergoing cardiac surgery, 24% of patients undergoing cardiac surgery have anaemia at surgery. Patients with a better hemoglobin prior to surgery have a lower risk of being transfused so it must be necessary to establish measures to improve the haemoglobin prior to cardiac surgery in order to improve outcome of this patients
Session topic: E-poster
Keyword(s): Blood transfusion, Outcome, Surgery, Survival
Type: Eposter Presentation
Background
Transfusion has been associated with a worse prognosis in patients undergoing cardiac surgery so restrictive attitude to transfuse had been proposed.
Aims
In order to assess the impact of transfusion in patients undergoing cardiac surgery we reviewed patients admitted to cardiac ICU.
Methods
Data concerning age, sex, reason for ICU admission, type of surgery, transfusion, preoperative haemoglobin, length of stay in the ICU, ICU survival, EUROSCORE prior to surgery and extracorporeal time from patients admitted in cardiac ICU of our hospital between January 2004 and June 2014 were collected. Univariate analysis with different variables and then a logistic regression model was
Results
We analysed data from 4,315 patients (63% male / 37% female) admitted to the unit during this period. Median age of 67.88 years (0-91 years). 93% were postoperative cardiac surgery. The most common reasons for surgery were valvular surgery (34.5%) coronary surgery (28%), coronary and valve surgery (18%). 3282 of patients (76.1%) were transfused. Patients undergoing valvular surgery were most frequently transfused than those who underwent coronary surgery (77% versus 66%). Transfused patients had lower haemoglobin at the time of surgery than those who were transfused (12.7 ± 1.7 versus 14, 51 ± 1.33, p <0.001). Of the total patients analysed, 23.7% had Hb <12 g / dl at the time of surgery. Of these, 97% were transfused compared to 69% who had Hb> 12 g / dl (p <0.001). Patients with Hb level> 12 g / dl had a survival of 95% versus 88% in the group with Hb <12 g / dl (p <0.001). 97% of non-transfused patients survive versus 88% of transfused patients (p <0.001) with a relative risk of survival of 3.87 (95% CI 2.67-5,99) within the group without transfusion.For most common types of surgery
| survival | OR (IC95%) survival | ||||
| coronary surgery | Transfusion | yes | 94% | P < 0.001 | |
| no | 99% | 8,26 (2.12-32.15 | |||
| Valvular surgery | Transfusion | yes | 92% | P < 0.001 | |
| no | 99% | 20.8 (2.9-144) | |||
| Valvular + coronary surgery | Transfusion | yes | 92% | P < 0.001 | |
| no | 98% | 3.83 (0.97-15) |
Conclusion
Transfusion is associated with a negative effect on the survival of patients undergoing cardiac surgery, 24% of patients undergoing cardiac surgery have anaemia at surgery. Patients with a better hemoglobin prior to surgery have a lower risk of being transfused so it must be necessary to establish measures to improve the haemoglobin prior to cardiac surgery in order to improve outcome of this patients
Session topic: E-poster
Keyword(s): Blood transfusion, Outcome, Surgery, Survival
Abstract: E1567
Type: Eposter Presentation
Background
Transfusion has been associated with a worse prognosis in patients undergoing cardiac surgery so restrictive attitude to transfuse had been proposed.
Aims
In order to assess the impact of transfusion in patients undergoing cardiac surgery we reviewed patients admitted to cardiac ICU.
Methods
Data concerning age, sex, reason for ICU admission, type of surgery, transfusion, preoperative haemoglobin, length of stay in the ICU, ICU survival, EUROSCORE prior to surgery and extracorporeal time from patients admitted in cardiac ICU of our hospital between January 2004 and June 2014 were collected. Univariate analysis with different variables and then a logistic regression model was
Results
We analysed data from 4,315 patients (63% male / 37% female) admitted to the unit during this period. Median age of 67.88 years (0-91 years). 93% were postoperative cardiac surgery. The most common reasons for surgery were valvular surgery (34.5%) coronary surgery (28%), coronary and valve surgery (18%). 3282 of patients (76.1%) were transfused. Patients undergoing valvular surgery were most frequently transfused than those who underwent coronary surgery (77% versus 66%). Transfused patients had lower haemoglobin at the time of surgery than those who were transfused (12.7 ± 1.7 versus 14, 51 ± 1.33, p <0.001). Of the total patients analysed, 23.7% had Hb <12 g / dl at the time of surgery. Of these, 97% were transfused compared to 69% who had Hb> 12 g / dl (p <0.001). Patients with Hb level> 12 g / dl had a survival of 95% versus 88% in the group with Hb <12 g / dl (p <0.001). 97% of non-transfused patients survive versus 88% of transfused patients (p <0.001) with a relative risk of survival of 3.87 (95% CI 2.67-5,99) within the group without transfusion.For most common types of surgery
Patients who were transfused had a shorter average length of stay in the ICU than those who were not (8.46 ± 3.95 days versus 15 ± 3.4, p <0.001)In the logistic regression analysis, the only variable that showed significant for survival was transfusion.
Conclusion
Transfusion is associated with a negative effect on the survival of patients undergoing cardiac surgery, 24% of patients undergoing cardiac surgery have anaemia at surgery. Patients with a better hemoglobin prior to surgery have a lower risk of being transfused so it must be necessary to establish measures to improve the haemoglobin prior to cardiac surgery in order to improve outcome of this patients
Session topic: E-poster
Keyword(s): Blood transfusion, Outcome, Surgery, Survival
Type: Eposter Presentation
Background
Transfusion has been associated with a worse prognosis in patients undergoing cardiac surgery so restrictive attitude to transfuse had been proposed.
Aims
In order to assess the impact of transfusion in patients undergoing cardiac surgery we reviewed patients admitted to cardiac ICU.
Methods
Data concerning age, sex, reason for ICU admission, type of surgery, transfusion, preoperative haemoglobin, length of stay in the ICU, ICU survival, EUROSCORE prior to surgery and extracorporeal time from patients admitted in cardiac ICU of our hospital between January 2004 and June 2014 were collected. Univariate analysis with different variables and then a logistic regression model was
Results
We analysed data from 4,315 patients (63% male / 37% female) admitted to the unit during this period. Median age of 67.88 years (0-91 years). 93% were postoperative cardiac surgery. The most common reasons for surgery were valvular surgery (34.5%) coronary surgery (28%), coronary and valve surgery (18%). 3282 of patients (76.1%) were transfused. Patients undergoing valvular surgery were most frequently transfused than those who underwent coronary surgery (77% versus 66%). Transfused patients had lower haemoglobin at the time of surgery than those who were transfused (12.7 ± 1.7 versus 14, 51 ± 1.33, p <0.001). Of the total patients analysed, 23.7% had Hb <12 g / dl at the time of surgery. Of these, 97% were transfused compared to 69% who had Hb> 12 g / dl (p <0.001). Patients with Hb level> 12 g / dl had a survival of 95% versus 88% in the group with Hb <12 g / dl (p <0.001). 97% of non-transfused patients survive versus 88% of transfused patients (p <0.001) with a relative risk of survival of 3.87 (95% CI 2.67-5,99) within the group without transfusion.For most common types of surgery
| survival | OR (IC95%) survival | ||||
| coronary surgery | Transfusion | yes | 94% | P < 0.001 | |
| no | 99% | 8,26 (2.12-32.15 | |||
| Valvular surgery | Transfusion | yes | 92% | P < 0.001 | |
| no | 99% | 20.8 (2.9-144) | |||
| Valvular + coronary surgery | Transfusion | yes | 92% | P < 0.001 | |
| no | 98% | 3.83 (0.97-15) |
Conclusion
Transfusion is associated with a negative effect on the survival of patients undergoing cardiac surgery, 24% of patients undergoing cardiac surgery have anaemia at surgery. Patients with a better hemoglobin prior to surgery have a lower risk of being transfused so it must be necessary to establish measures to improve the haemoglobin prior to cardiac surgery in order to improve outcome of this patients
Session topic: E-poster
Keyword(s): Blood transfusion, Outcome, Surgery, Survival
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