Intra-operative red blood cell transfusion and mortality after cardiac surgery (2024)

Vlot, E. A., Verwijmeren, L., van de Garde, E. M. W., Kloppenburg, G. T. L., van Dongen, E. P. A., & Noordzij, P. G. (2019). Intra-operative red blood cell transfusion and mortality after cardiac surgery. Anesthesiology, 19(1), Article 65. https://doi.org/10.1186/s12871-019-0738-2

Vlot, Eline A ; Verwijmeren, Lisa ; van de Garde, Ewoudt M W et al. / Intra-operative red blood cell transfusion and mortality after cardiac surgery. In: Anesthesiology. 2019 ; Vol. 19, No. 1.

@article{d26e350f92d54fe3a75bbe18edc9e504,

title = "Intra-operative red blood cell transfusion and mortality after cardiac surgery",

abstract = "BACKGROUND: Anemia in cardiac surgery patients has been associated with poor outcomes. Transfusion of red blood cells during surgery is common practice for perioperative anemia, but may come with risks. Little is known about the association between intra-operative transfusion and mortality in patients undergoing cardiac surgery.METHODS: Single centre historical cohort study in 2933 adult patients undergoing coronary surgery with or without aortic valve replacement from June 2011 until September 2014. To estimate the odds ratio for mortality in patients receiving intra-operative transfusion, a propensity score based logistic regression analysis was performed.RESULTS: Intra-operative transfusion was associated with a more than three-fold increased risk of 30-day mortality. Patients in the highest quartile of probability of transfusion were older (age 75 vs 66; P <  0.001), had a higher EuroSCORE (6 vs 3; P <  0.001), had lower preoperative hemoglobin levels (7.6 vs 8.9 mmol/l; P < 0.001), had combined surgery more often (CABG + AVR in 33.4% of cases vs 6.6% (P < 0.001) and a longer duration of surgery (224 vs 188 min; P < 0.001). The association between intra-operative transfusion and mortality persisted after adjustment for these risk factors (adjusted OR 2.6; P = 0.007).CONCLUSIONS: Intra-operative transfusion of red blood cells was found to be associated with increased mortality in adults undergoing coronary surgery. Preoperative patient optimization may improve perioperative outcomes by reducing the likelihood of requiring transfusion and thus its associated risk.",

keywords = "Blood transfusion, Cardiac surgery, Postoperative mortality",

author = "Vlot, {Eline A} and Lisa Verwijmeren and {van de Garde}, {Ewoudt M W} and Kloppenburg, {Geoffrey T L} and {van Dongen}, {Eric P A} and Noordzij, {Peter G}",

year = "2019",

month = may,

day = "4",

doi = "10.1186/s12871-019-0738-2",

language = "English",

volume = "19",

journal = "Anesthesiology",

issn = "0003-3022",

publisher = "Lippincott Williams and Wilkins",

number = "1",

}

Vlot, EA, Verwijmeren, L, van de Garde, EMW, Kloppenburg, GTL, van Dongen, EPA & Noordzij, PG 2019, 'Intra-operative red blood cell transfusion and mortality after cardiac surgery', Anesthesiology, vol. 19, no. 1, 65. https://doi.org/10.1186/s12871-019-0738-2

Intra-operative red blood cell transfusion and mortality after cardiac surgery. / Vlot, Eline A; Verwijmeren, Lisa; van de Garde, Ewoudt M W et al.
In: Anesthesiology, Vol. 19, No. 1, 65, 04.05.2019.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Intra-operative red blood cell transfusion and mortality after cardiac surgery

AU - Vlot, Eline A

AU - Verwijmeren, Lisa

AU - van de Garde, Ewoudt M W

AU - Kloppenburg, Geoffrey T L

AU - van Dongen, Eric P A

AU - Noordzij, Peter G

PY - 2019/5/4

Y1 - 2019/5/4

N2 - BACKGROUND: Anemia in cardiac surgery patients has been associated with poor outcomes. Transfusion of red blood cells during surgery is common practice for perioperative anemia, but may come with risks. Little is known about the association between intra-operative transfusion and mortality in patients undergoing cardiac surgery.METHODS: Single centre historical cohort study in 2933 adult patients undergoing coronary surgery with or without aortic valve replacement from June 2011 until September 2014. To estimate the odds ratio for mortality in patients receiving intra-operative transfusion, a propensity score based logistic regression analysis was performed.RESULTS: Intra-operative transfusion was associated with a more than three-fold increased risk of 30-day mortality. Patients in the highest quartile of probability of transfusion were older (age 75 vs 66; P <  0.001), had a higher EuroSCORE (6 vs 3; P <  0.001), had lower preoperative hemoglobin levels (7.6 vs 8.9 mmol/l; P < 0.001), had combined surgery more often (CABG + AVR in 33.4% of cases vs 6.6% (P < 0.001) and a longer duration of surgery (224 vs 188 min; P < 0.001). The association between intra-operative transfusion and mortality persisted after adjustment for these risk factors (adjusted OR 2.6; P = 0.007).CONCLUSIONS: Intra-operative transfusion of red blood cells was found to be associated with increased mortality in adults undergoing coronary surgery. Preoperative patient optimization may improve perioperative outcomes by reducing the likelihood of requiring transfusion and thus its associated risk.

AB - BACKGROUND: Anemia in cardiac surgery patients has been associated with poor outcomes. Transfusion of red blood cells during surgery is common practice for perioperative anemia, but may come with risks. Little is known about the association between intra-operative transfusion and mortality in patients undergoing cardiac surgery.METHODS: Single centre historical cohort study in 2933 adult patients undergoing coronary surgery with or without aortic valve replacement from June 2011 until September 2014. To estimate the odds ratio for mortality in patients receiving intra-operative transfusion, a propensity score based logistic regression analysis was performed.RESULTS: Intra-operative transfusion was associated with a more than three-fold increased risk of 30-day mortality. Patients in the highest quartile of probability of transfusion were older (age 75 vs 66; P <  0.001), had a higher EuroSCORE (6 vs 3; P <  0.001), had lower preoperative hemoglobin levels (7.6 vs 8.9 mmol/l; P < 0.001), had combined surgery more often (CABG + AVR in 33.4% of cases vs 6.6% (P < 0.001) and a longer duration of surgery (224 vs 188 min; P < 0.001). The association between intra-operative transfusion and mortality persisted after adjustment for these risk factors (adjusted OR 2.6; P = 0.007).CONCLUSIONS: Intra-operative transfusion of red blood cells was found to be associated with increased mortality in adults undergoing coronary surgery. Preoperative patient optimization may improve perioperative outcomes by reducing the likelihood of requiring transfusion and thus its associated risk.

KW - Blood transfusion

KW - Cardiac surgery

KW - Postoperative mortality

U2 - 10.1186/s12871-019-0738-2

DO - 10.1186/s12871-019-0738-2

M3 - Article

C2 - 31054585

SN - 0003-3022

VL - 19

JO - Anesthesiology

JF - Anesthesiology

IS - 1

M1 - 65

ER -

Vlot EA, Verwijmeren L, van de Garde EMW, Kloppenburg GTL, van Dongen EPA, Noordzij PG. Intra-operative red blood cell transfusion and mortality after cardiac surgery. Anesthesiology. 2019 May 4;19(1):65. doi: 10.1186/s12871-019-0738-2