Effects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland - a retrospective cohort study.

Autor: Obonyo NG; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia. g.obonyo@uq.edu.au.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia. g.obonyo@uq.edu.au.; Initiative to Develop African Research Leaders (IDeAL), KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya. g.obonyo@uq.edu.au.; Wellcome Trust Centre for Global Health Research, Imperial College London, London, UK. g.obonyo@uq.edu.au.; Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia. g.obonyo@uq.edu.au., Dhanapathy V; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; School of Medicine, Griffith University, Gold Coast, QLD, Australia., White N; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia., Sela DP; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia., Rachakonda RH; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia., Tunbridge M; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia., Sim B; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia., Teo D; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia., Nadeem Z; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia., See Hoe LE; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia.; School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia., Bassi GL; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia.; Wesley Medical Research, The Wesley Foundation, Auchenflower, Brisbane, QLD, Australia.; Intensive Care Unit, St Andrew's War Memorial Hospital, Spring Hill, Brisbane, QLD, Australia.; Intensive Care Unit, The Wesley Hospital, Auchenflower, Brisbane, QLD, Australia.; Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia., Fanning JP; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia.; Nuffield Department of Population Health, University of Oxford, Oxford, UK.; Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA., Tung JP; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia.; Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, QLD, Australia.; Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia., Suen JY; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia., Fraser JF; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Institute of Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia.; Intensive Care Unit, St Andrew's War Memorial Hospital, Spring Hill, Brisbane, QLD, Australia.; Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.; School of Medicine, Griffith University, Gold Coast, QLD, Australia.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic surgery [J Cardiothorac Surg] 2024 Aug 01; Vol. 19 (1), pp. 475. Date of Electronic Publication: 2024 Aug 01.
DOI: 10.1186/s13019-024-02974-7
Abstrakt: Background: Packed red blood cell (pRBC) transfusion is a relatively safe and mainstay treatment commonly used in cardiac surgical patients. However, there is limited evidence on clinical effects of transfusing blood nearing end-of shelf life that has undergone biochemical changes during storage.
Objective: To investigate evidence of associations between morbidity/mortality and transfusion of blood near end of shelf-life (> 35 days) in cardiac surgical patients.
Methods: Data from the Queensland Health Admitted Patient Data Collection database 2007-2013 was retrospectively analysed. Coronary artery bypass graft and valvular repair patients were included. Multivariable logistic regression was used to examine the effect of pRBC age (< 35 days vs. ≥ 35 days) on in-hospital mortality and morbidity. As secondary analysis, outcomes associated with the number of pRBC units transfused (≤ 4 units vs. ≥ 5 units) were also assessed.
Results: A total of 4514 cardiac surgery patients received pRBC transfusion. Of these, 292 (6.5%) received pRBCs ≥ 35 days. No difference in in-hospital mortality or frequency of complications was observed. Transfusion of ≥ 5 units of pRBCs compared to the ≤ 4 units was associated with higher rates of in-hospital mortality (5.6% vs. 1.3%), acute renal failure (17.6% vs. 8%), infection (10% vs. 3.4%), and acute myocardial infarction (9.2% vs. 4.3%). Infection carried an odds ratio of 1.37 between groups (CI = 0.9-2.09; p = 0.14) and stroke/neurological complications, 1.59 (CI = 0.96-2.63; p = 0.07).
Conclusion: In cardiac surgery patients, transfusion of pRBCs closer to end of shelf-life was not shown to be associated with significantly increased mortality or morbidity. Dose-dependent differences in adverse outcomes (particularly where units transfused were > 4) were supported.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje