The impact of minor blood transfusion on the outcome after coronary artery bypass grafting
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The impact of minor blood transfusion on the outcome after coronary artery bypass grafting. / Kinnunen, Eeva-Maija; Zanobini, Marco; Onorati, Francesco; Brascia, Debora; Mariscalco, Giovanni; Franzese, Ilaria; Ruggieri, Vito G; Bounader, Karl; Perrotti, Andrea; Musumeci, Francesco; Santarpino, Giuseppe; Maselli, Daniele; Nardella, Saverio; Gulbins, Helmut; Gherli, Riccardo; Rubino, Antonino S; Mignosa, Carmelo; De Feo, Marisa; Gatti, Giuseppe; Santini, Francesco; Salsano, Antonio; Dalén, Magnus; Saccocci, Matteo; Reichart, Daniel; Faggian, Giuseppe; Gherli, Tiziano; Nicolini, Francesco; Biancari, Fausto.
in: J CRIT CARE, Jahrgang 40, 08.2017, S. 207-212.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - The impact of minor blood transfusion on the outcome after coronary artery bypass grafting
AU - Kinnunen, Eeva-Maija
AU - Zanobini, Marco
AU - Onorati, Francesco
AU - Brascia, Debora
AU - Mariscalco, Giovanni
AU - Franzese, Ilaria
AU - Ruggieri, Vito G
AU - Bounader, Karl
AU - Perrotti, Andrea
AU - Musumeci, Francesco
AU - Santarpino, Giuseppe
AU - Maselli, Daniele
AU - Nardella, Saverio
AU - Gulbins, Helmut
AU - Gherli, Riccardo
AU - Rubino, Antonino S
AU - Mignosa, Carmelo
AU - De Feo, Marisa
AU - Gatti, Giuseppe
AU - Santini, Francesco
AU - Salsano, Antonio
AU - Dalén, Magnus
AU - Saccocci, Matteo
AU - Reichart, Daniel
AU - Faggian, Giuseppe
AU - Gherli, Tiziano
AU - Nicolini, Francesco
AU - Biancari, Fausto
N1 - Copyright © 2017 Elsevier Inc. All rights reserved.
PY - 2017/8
Y1 - 2017/8
N2 - PURPOSE: To investigate the impact of minor perioperative bleeding requiring transfusion of 1-2 red blood cell (RBC) units on the outcome after coronary artery bypass grafting (CABG).METHODS: Sixteen cardiac surgical centers contributed to the prospective European CABG registry (E-CABG). 1014 patients receiving 1-2 RBC units during or after isolated CABG were compared to 2264 patients not receiving RBCs.RESULTS: In 827 propensity score matched pairs, transfusion of 1-2 RBC units did not affect the risk of in-hospital/30-day death (p=0.523) or stroke (p=0.804). However, RBC transfusion was associated with an increased risk of acute kidney injury (p=0.008), sternal wound infection (p=0.001), postoperative use of antibiotics (p=0.001), prolonged use of inotropes (p<0.0001), use of intra-aortic balloon pump (p=0.012), length of intensive care unit stay (p<0.0001) and length of in-hospital stay (p<0.0001). Matched paired analysis excluding pre- and postoperative critical hemodynamic conditions showed that RBC transfusion was associated with an increased risk of major complications except in-hospital/30-day death.CONCLUSION: Minor perioperative bleeding and subsequent transfusion of 1-2 RBC units did not affect the risk of early death, but increased the risk of other major adverse events. Minimizing perioperative bleeding and prevention of even low-volume RBC transfusion may improve the outcome after CABG.
AB - PURPOSE: To investigate the impact of minor perioperative bleeding requiring transfusion of 1-2 red blood cell (RBC) units on the outcome after coronary artery bypass grafting (CABG).METHODS: Sixteen cardiac surgical centers contributed to the prospective European CABG registry (E-CABG). 1014 patients receiving 1-2 RBC units during or after isolated CABG were compared to 2264 patients not receiving RBCs.RESULTS: In 827 propensity score matched pairs, transfusion of 1-2 RBC units did not affect the risk of in-hospital/30-day death (p=0.523) or stroke (p=0.804). However, RBC transfusion was associated with an increased risk of acute kidney injury (p=0.008), sternal wound infection (p=0.001), postoperative use of antibiotics (p=0.001), prolonged use of inotropes (p<0.0001), use of intra-aortic balloon pump (p=0.012), length of intensive care unit stay (p<0.0001) and length of in-hospital stay (p<0.0001). Matched paired analysis excluding pre- and postoperative critical hemodynamic conditions showed that RBC transfusion was associated with an increased risk of major complications except in-hospital/30-day death.CONCLUSION: Minor perioperative bleeding and subsequent transfusion of 1-2 RBC units did not affect the risk of early death, but increased the risk of other major adverse events. Minimizing perioperative bleeding and prevention of even low-volume RBC transfusion may improve the outcome after CABG.
KW - Acute Kidney Injury/mortality
KW - Aged
KW - Blood Transfusion
KW - Coronary Artery Bypass
KW - Europe
KW - Female
KW - Hemorrhage/mortality
KW - Humans
KW - Intensive Care Units
KW - Intraoperative Period
KW - Male
KW - Postoperative Complications/mortality
KW - Propensity Score
KW - Prospective Studies
KW - Registries
KW - Stroke/mortality
KW - Surgical Wound Infection/mortality
KW - Treatment Outcome
U2 - 10.1016/j.jcrc.2017.04.025
DO - 10.1016/j.jcrc.2017.04.025
M3 - SCORING: Journal article
C2 - 28445858
VL - 40
SP - 207
EP - 212
JO - J CRIT CARE
JF - J CRIT CARE
SN - 0883-9441
ER -