Abstract
BackgroundBlood transfusion is a commonly used therapy in cardiac surgery, whether it is given during the surgery or in the intensive care unit. It is important to evaluate the risks and benefits of exposure to blood transfusion. The use of blood transfusions can influence patient outcome. Previous studies have implicated blood transfusion as a causative factor in post-operative infection.ObjectivesWe aim to determine the effect of blood transfusion on post-operative infection in cardiac surgery patients at the King Faisal Cardiac Center, Jeddah, Saudia Arabia, from January 2017 to January 2019.MethodsThe regular six-week follow-up of cardiac surgery patients allowed us to maintain a six-week infection span. The main variables included patient characteristics, operative characteristics, pre-operative hemoglobin, six-week infection, blood transfusion, and clinical outcomes. A logistic regression model was developed to identify patient and procedure variables that were associated with blood transfusion and infection. The baseline variables were entered into the model. Variables with p-value less than 0.05 were considered significant.ResultsThe incidence of transfusion out of 197 patients was 93.4% (n = 184). The occurrence of infection was 31.82% (n = 63). There was no difference in post-operative infection for patients who received blood transfusions compared with those who did not receive blood transfusions (p = 0.902). In comparing patients receiving 1-2 units of red blood cells (RBCs) (48%) and those receiving >2 units of RBCs (52%), there was no significance (p = 0.549).ConclusionsThere was no association between the incidence of infection and blood transfusion. While there are other reasons for withholding blood, it would not be recommended to do so based on the concern of infection.
Highlights
Cardiac surgery is a very demanding intervention that is increasingly performed, and it will continue to rise due to the increasing age of the population
There was no difference in post-operative infection for patients who received blood transfusions compared with those who did not receive blood transfusions (p = 0.902)
There was no association between the incidence of infection and blood transfusion
Summary
Cardiac surgery is a very demanding intervention that is increasingly performed, and it will continue to rise due to the increasing age of the population. CAD is a widespread and often fatal disease that is responsible for more than one-third of the deaths in individuals 35 years or older [1,2] Both CAD and valvular disorders are commonly treated surgically which exposes patients to peri-operative complications. A study found that roughly 60% of coronary artery bypass graft surgery (CABG) patients receive a blood transfusion [6], but figures vary from 0% to 75%. Due to this variability, it is necessary to evaluate the risk and complications that a patient undergoing cardiac surgery is exposed to by receiving a blood transfusion. Previous studies have implicated blood transfusion as a causative factor in post-operative infection
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