Cardiothoracic and Vascular Anesthesia

Blood transfusion after cardiac surgery: is it the patient or the transfusion that carries the risk?

Dardashti A, Ederoth P, Algotsson L, et al (Lund Univ, Sweden) Acta Anaesthesiol Scand 55:952-961, 2011^§

Abstract

Background

The transfusion of red blood cells (RBCs) after cardiac surgery has been associated with increased long-term mortality. This study reexamines this hypothesis by including pre-operative hemoglobin (Hb) levels and renal function in the analysis.

Methods

A retrospective single-center study was performed including 5261 coronary artery bypass grafting (CABG) patients in a Cox proportional hazard survival analysis. Patients with more than eight RBC transfusions, early death (7 days), and emergent cases were excluded. Patients were followed for 7.5 years. Previously known risk factors were entered into the analysis together with pre-operative Hb and estimated glomerular filtration rate (eGFR). In addition, subgroups were formed based on the patients’ pre-operative renal function and Hb levels.

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