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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, Vol. 40, 08.2017, p. 207-212.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Kinnunen, E-M, Zanobini, M, Onorati, F, Brascia, D, Mariscalco, G, Franzese, I, Ruggieri, VG, Bounader, K, Perrotti, A, Musumeci, F, Santarpino, G, Maselli, D, Nardella, S, Gulbins, H, Gherli, R, Rubino, AS, Mignosa, C, De Feo, M, Gatti, G, Santini, F, Salsano, A, Dalén, M, Saccocci, M, Reichart, D, Faggian, G, Gherli, T, Nicolini, F & Biancari, F 2017, 'The impact of minor blood transfusion on the outcome after coronary artery bypass grafting', J CRIT CARE, vol. 40, pp. 207-212. https://doi.org/10.1016/j.jcrc.2017.04.025

APA

Kinnunen, E-M., Zanobini, M., Onorati, F., Brascia, D., Mariscalco, G., Franzese, I., Ruggieri, V. G., Bounader, K., Perrotti, A., Musumeci, F., Santarpino, G., Maselli, D., Nardella, S., Gulbins, H., Gherli, R., Rubino, A. S., Mignosa, C., De Feo, M., Gatti, G., ... Biancari, F. (2017). The impact of minor blood transfusion on the outcome after coronary artery bypass grafting. J CRIT CARE, 40, 207-212. https://doi.org/10.1016/j.jcrc.2017.04.025

Vancouver

Kinnunen E-M, Zanobini M, Onorati F, Brascia D, Mariscalco G, Franzese I et al. The impact of minor blood transfusion on the outcome after coronary artery bypass grafting. J CRIT CARE. 2017 Aug;40:207-212. https://doi.org/10.1016/j.jcrc.2017.04.025

Bibtex

@article{d638e4f3044b4272a5eae608fb87ec7a,
title = "The impact of minor blood transfusion on the outcome after coronary artery bypass grafting",
abstract = "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.",
keywords = "Acute Kidney Injury/mortality, Aged, Blood Transfusion, Coronary Artery Bypass, Europe, Female, Hemorrhage/mortality, Humans, Intensive Care Units, Intraoperative Period, Male, Postoperative Complications/mortality, Propensity Score, Prospective Studies, Registries, Stroke/mortality, Surgical Wound Infection/mortality, Treatment Outcome",
author = "Eeva-Maija Kinnunen and Marco Zanobini and Francesco Onorati and Debora Brascia and Giovanni Mariscalco and Ilaria Franzese and Ruggieri, {Vito G} and Karl Bounader and Andrea Perrotti and Francesco Musumeci and Giuseppe Santarpino and Daniele Maselli and Saverio Nardella and Helmut Gulbins and Riccardo Gherli and Rubino, {Antonino S} and Carmelo Mignosa and {De Feo}, Marisa and Giuseppe Gatti and Francesco Santini and Antonio Salsano and Magnus Dal{\'e}n and Matteo Saccocci and Daniel Reichart and Giuseppe Faggian and Tiziano Gherli and Francesco Nicolini and Fausto Biancari",
note = "Copyright {\textcopyright} 2017 Elsevier Inc. All rights reserved.",
year = "2017",
month = aug,
doi = "10.1016/j.jcrc.2017.04.025",
language = "English",
volume = "40",
pages = "207--212",
journal = "J CRIT CARE",
issn = "0883-9441",
publisher = "Elsevier BV",

}

RIS

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 -