Major transfusions remain frequent despite the generalized use of tranexamic acid: an audit of 3322 patients undergoing cardiac surgery

Stevens, Louis-Mathieu; Noiseux, Nicolas; Priéto, Ignacio; Hardy, Jean‐François

doi:10.1111/trf.13615

Cited by 5 publications

(1 citation statement)

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“…Predictors of blood transfusion in our analyses were similar to the TRACS trial, which showed higher transfusion rates in patients with previous cardiac surgery (OR = 8.92; p = 0.04), longer duration of cardiopulmonary bypass (OR = 1.01; p = 0.03) and lower preoperative hemoglobin levels (OR = 0.51; p = 0.001), 9 and to Stevens et al, 17 who reported as predictors: CKD, previous cardiac surgery, urgency surgery, ejection fraction, type of surgery, CPB duration, age and low body mass index, although the last two was not confirmed in our study.…”

Section: Discussionsupporting

confidence: 85%

Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study

Tagliari

Silveira

Kochi

et al. 2019

International Journal of Cardiovascular Sciences

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Background: Hemodilution, transoperative bleeding and cardiopulmonary bypass (CPB) are some of the factors associated with high transfusion rates in cardiac surgery. Objective:To analyze the incidence of blood transfusion and early postoperative outcomes in cardiac surgery patients.Methods: Cohort study of patients undergoing cardiac surgery in a university hospital, consecutively enrolled from May 2015 to February 2017. Data were prospectively collected and comparisons were made between two patients' groups: transfused and not transfused. Student's t-test, chi-square test, and logistic regression were used, and a p-value < 0.05 was considered significant.Results: Among the 271 patients evaluated, 100 (37%) required transfusion in the transoperative (32.1%) and/or postoperative periods (19.5%). The following predictors of transfusion were identified by multivariate analysis: EuroScore II (OR 1.2); chronic kidney disease (CKD) (OR 3.2); transoperative bleeding ≥ 500 mL (OR 6.7); baseline hemoglobin (Hb) ≤ 10 g/dL (OR 11.5); activated partial thromboplastin time (aPTT) (OR 1.1) and CPB duration (OR 1.03). Transfusion was associated with prolonged mechanical ventilation (≥ 24h) (2.4% vs. 23%), delirium (5.9% vs. 18%), bronchopneumonia (1.2% vs. 16%), acute renal failure (3.5% vs. 25%), acute on CKD (0.6% vs. 8%), stroke or transient ischemic attack (1.8% vs. 8%), intensive care unit stay ≥ 72 h (36% vs. 57%), longer hospital stay (8 ± 4 days vs. 16 ± 15 days), as well as increased early mortality (1.75% vs. 15%). Conclusion:EuroScore II, CKD, major transoperative bleeding, preoperative Hb and aPTT values and CPB time were independent predictors of transfusion, which was associated with a higher rate of adverse outcomes, including early mortality.

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Section: Discussionsupporting

confidence: 85%