Abstract
BackgroundAllogeneic red blood cell (RBC) transfusion has been proposed as a negative indicator of quality in cardiac surgery. Hospital length of stay (LOS) may be a surrogate of poor outcome in transfused patients.MethodsData from 502 patients included in Transfusion Requirements After Cardiac Surgery (TRACS) study were analyzed to assess the relationship between RBC transfusion and hospital LOS in patients undergoing cardiac surgery and enrolled in the TRACS study.ResultsAccording to the status of RBC transfusion, patients were categorized into the following three groups: 1) 199 patients (40%) who did not receive RBC, 2) 241 patients (48%) who received 3 RBC units or fewer (low transfusion requirement group), and 3) 62 patients (12%) who received more than 3 RBC units (high transfusion requirement group). In a multivariable Cox proportional hazards model, the following factors were predictive of a prolonged hospital length of stay: age higher than 65 years, EuroSCORE, valvular surgery, combined procedure, LVEF lower than 40% and RBC transfusion of > 3 units.ConclusionRBC transfusion is an independent risk factor for increased LOS in patients undergoing cardiac surgery. This finding highlights the adequacy of a restrictive transfusion therapy in patients undergoing cardiac surgery.Trial registrationClinicaltrials.gov identifier: http://NCT01021631.
Highlights
Allogeneic red blood cell (RBC) transfusion has been proposed as a negative indicator of quality in cardiac surgery
The following factors were predictive of a prolonged hospital length of stay: age higher than 65 years, EuroSCORE higher than 3–5 (HR 1.46 [1.13-1.88]; p = 0.003, EuroSCORE higher than 5 (HR, 1.71 [95% confidence interval (CI), transfusion of > 3 units (HR, 2 [95% CI, 1.44–2.79]; p < 0.001) (Table 2)
In a multivariable model adjusted for univariate associations, RBC transfusion was a predictor of longer hospital length of stay, and the strongest association was found in the high transfusion group
Summary
Allogeneic red blood cell (RBC) transfusion has been proposed as a negative indicator of quality in cardiac surgery. The rationale for perioperative red blood cell (RBC) transfusion is based on the observations that anemia is an independent risk factor for morbidity and mortality after cardiac surgery and that red blood cell transfusion would benefit a subset of patients presenting tissue hypoperfusion [1,2]. The primary objective of this study was to assess the relationship between RBC transfusion and hospital length of stay in a large, single reference center of cardiac surgery. Secondary objectives were to compare the characteristics of patients who received RBC transfusion with those who did not, to evaluate the relationship of the number of transfused RBC units with mortality and clinical complications, and to identify the predictive factors for a prolonged hospital LOS. We hypothesized that patients requiring early postoperative blood transfusion would have longer hospital length of stay
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
