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Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study
Tagliari, Ana Paula; Silveira, Lucas Molinari Veloso da; Kochi, Adriano Nunes; Souza, Anderson Castro de; Gib, Marcelo Curcio; Freitas, Tanara Martins de; Martins, Cristiano Blaya; Cavazzola, Leandro Totti; Wender, Orlando Carlos Belmonte.
  • Tagliari, Ana Paula; Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre. BR
  • Silveira, Lucas Molinari Veloso da; Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre. BR
  • Kochi, Adriano Nunes; Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre. BR
  • Souza, Anderson Castro de; Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre. BR
  • Gib, Marcelo Curcio; Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre. BR
  • Freitas, Tanara Martins de; Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre. BR
  • Martins, Cristiano Blaya; Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre. BR
  • Cavazzola, Leandro Totti; Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre. BR
  • Wender, Orlando Carlos Belmonte; Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre. BR
Int. j. cardiovasc. sci. (Impr.) ; 32(6): 565-572, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1056371
ABSTRACT
Abstract

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.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Postoperative Complications / Blood Transfusion / Intraoperative Care Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Humans / Male Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal do Rio Grande do Sul (UFRGS)/BR

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Full text: Available Index: LILACS (Americas) Main subject: Postoperative Complications / Blood Transfusion / Intraoperative Care Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Humans / Male Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal do Rio Grande do Sul (UFRGS)/BR