Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | International Journal of Cardiovascular Sciences (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472019000600565 |
Resumo: | Abstract Background: Hemodilution, transoperative bleeding and cardiopulmonary bypass (CPB) are some of the factors associated with high transfusion rates in cardiac surgery. Objective: To analyze the incidence of blood transfusion and early postoperative outcomes in cardiac surgery patients. Methods: Cohort study of patients undergoing cardiac surgery in a university hospital, consecutively enrolled from May 2015 to February 2017. Data were prospectively collected and comparisons were made between two patients’ groups: transfused and not transfused. Student's t-test, chi-square test, and logistic regression were used, and a p-value < 0.05 was considered significant. Results: Among the 271 patients evaluated, 100 (37%) required transfusion in the transoperative (32.1%) and/or postoperative periods (19.5%). The following predictors of transfusion were identified by multivariate analysis: EuroScore II (OR 1.2); chronic kidney disease (CKD) (OR 3.2); transoperative bleeding ≥ 500 mL (OR 6.7); baseline hemoglobin (Hb) ≤ 10 g/dL (OR 11.5); activated partial thromboplastin time (aPTT) (OR 1.1) and CPB duration (OR 1.03). Transfusion was associated with prolonged mechanical ventilation (≥ 24h) (2.4% vs. 23%), delirium (5.9% vs. 18%), bronchopneumonia (1.2% vs. 16%), acute renal failure (3.5% vs. 25%), acute on CKD (0.6% vs. 8%), stroke or transient ischemic attack (1.8% vs. 8%), intensive care unit stay ≥ 72 h (36% vs. 57%), longer hospital stay (8 ± 4 days vs. 16 ± 15 days), as well as increased early mortality (1.75% vs. 15%). Conclusion: EuroScore II, CKD, major transoperative bleeding, preoperative Hb and aPTT values and CPB time were independent predictors of transfusion, which was associated with a higher rate of adverse outcomes, including early mortality. |
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International Journal of Cardiovascular Sciences (Online) |
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Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort StudyCardiac Surgical Procedures/mortalityBlood TransfusionIntraoperative Care/adverse effectsPostoperative Complications/prevention and controlRisk assessmentAbstract Background: Hemodilution, transoperative bleeding and cardiopulmonary bypass (CPB) are some of the factors associated with high transfusion rates in cardiac surgery. Objective: To analyze the incidence of blood transfusion and early postoperative outcomes in cardiac surgery patients. Methods: Cohort study of patients undergoing cardiac surgery in a university hospital, consecutively enrolled from May 2015 to February 2017. Data were prospectively collected and comparisons were made between two patients’ groups: transfused and not transfused. Student's t-test, chi-square test, and logistic regression were used, and a p-value < 0.05 was considered significant. Results: Among the 271 patients evaluated, 100 (37%) required transfusion in the transoperative (32.1%) and/or postoperative periods (19.5%). The following predictors of transfusion were identified by multivariate analysis: EuroScore II (OR 1.2); chronic kidney disease (CKD) (OR 3.2); transoperative bleeding ≥ 500 mL (OR 6.7); baseline hemoglobin (Hb) ≤ 10 g/dL (OR 11.5); activated partial thromboplastin time (aPTT) (OR 1.1) and CPB duration (OR 1.03). Transfusion was associated with prolonged mechanical ventilation (≥ 24h) (2.4% vs. 23%), delirium (5.9% vs. 18%), bronchopneumonia (1.2% vs. 16%), acute renal failure (3.5% vs. 25%), acute on CKD (0.6% vs. 8%), stroke or transient ischemic attack (1.8% vs. 8%), intensive care unit stay ≥ 72 h (36% vs. 57%), longer hospital stay (8 ± 4 days vs. 16 ± 15 days), as well as increased early mortality (1.75% vs. 15%). Conclusion: EuroScore II, CKD, major transoperative bleeding, preoperative Hb and aPTT values and CPB time were independent predictors of transfusion, which was associated with a higher rate of adverse outcomes, including early mortality.Sociedade Brasileira de Cardiologia2019-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472019000600565International Journal of Cardiovascular Sciences v.32 n.6 2019reponame:International Journal of Cardiovascular Sciences (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.5935/2359-4802.20190040info:eu-repo/semantics/openAccessTagliari,Ana PaulaSilveira,Lucas Molinari Veloso daKochi,Adriano NunesSouza,Anderson Castro deGib,Marcelo CurcioFreitas,Tanara Martins deMartins,Cristiano BlayaCavazzola,Leandro TottiWender,Orlando Carlos Belmonteeng2019-11-26T00:00:00Zoai:scielo:S2359-56472019000600565Revistahttp://publicacoes.cardiol.br/portal/ijcshttps://old.scielo.br/oai/scielo-oai.phptailanerodrigues@cardiol.br||revistaijcs@cardiol.br2359-56472359-4802opendoar:2019-11-26T00:00International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC)false |
dc.title.none.fl_str_mv |
Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study |
title |
Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study |
spellingShingle |
Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study Tagliari,Ana Paula Cardiac Surgical Procedures/mortality Blood Transfusion Intraoperative Care/adverse effects Postoperative Complications/prevention and control Risk assessment |
title_short |
Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study |
title_full |
Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study |
title_fullStr |
Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study |
title_full_unstemmed |
Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study |
title_sort |
Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study |
author |
Tagliari,Ana Paula |
author_facet |
Tagliari,Ana Paula Silveira,Lucas Molinari Veloso da Kochi,Adriano Nunes Souza,Anderson Castro de Gib,Marcelo Curcio Freitas,Tanara Martins de Martins,Cristiano Blaya Cavazzola,Leandro Totti Wender,Orlando Carlos Belmonte |
author_role |
author |
author2 |
Silveira,Lucas Molinari Veloso da Kochi,Adriano Nunes Souza,Anderson Castro de Gib,Marcelo Curcio Freitas,Tanara Martins de Martins,Cristiano Blaya Cavazzola,Leandro Totti Wender,Orlando Carlos Belmonte |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Tagliari,Ana Paula Silveira,Lucas Molinari Veloso da Kochi,Adriano Nunes Souza,Anderson Castro de Gib,Marcelo Curcio Freitas,Tanara Martins de Martins,Cristiano Blaya Cavazzola,Leandro Totti Wender,Orlando Carlos Belmonte |
dc.subject.por.fl_str_mv |
Cardiac Surgical Procedures/mortality Blood Transfusion Intraoperative Care/adverse effects Postoperative Complications/prevention and control Risk assessment |
topic |
Cardiac Surgical Procedures/mortality Blood Transfusion Intraoperative Care/adverse effects Postoperative Complications/prevention and control Risk assessment |
description |
Abstract Background: Hemodilution, transoperative bleeding and cardiopulmonary bypass (CPB) are some of the factors associated with high transfusion rates in cardiac surgery. Objective: To analyze the incidence of blood transfusion and early postoperative outcomes in cardiac surgery patients. Methods: Cohort study of patients undergoing cardiac surgery in a university hospital, consecutively enrolled from May 2015 to February 2017. Data were prospectively collected and comparisons were made between two patients’ groups: transfused and not transfused. Student's t-test, chi-square test, and logistic regression were used, and a p-value < 0.05 was considered significant. Results: Among the 271 patients evaluated, 100 (37%) required transfusion in the transoperative (32.1%) and/or postoperative periods (19.5%). The following predictors of transfusion were identified by multivariate analysis: EuroScore II (OR 1.2); chronic kidney disease (CKD) (OR 3.2); transoperative bleeding ≥ 500 mL (OR 6.7); baseline hemoglobin (Hb) ≤ 10 g/dL (OR 11.5); activated partial thromboplastin time (aPTT) (OR 1.1) and CPB duration (OR 1.03). Transfusion was associated with prolonged mechanical ventilation (≥ 24h) (2.4% vs. 23%), delirium (5.9% vs. 18%), bronchopneumonia (1.2% vs. 16%), acute renal failure (3.5% vs. 25%), acute on CKD (0.6% vs. 8%), stroke or transient ischemic attack (1.8% vs. 8%), intensive care unit stay ≥ 72 h (36% vs. 57%), longer hospital stay (8 ± 4 days vs. 16 ± 15 days), as well as increased early mortality (1.75% vs. 15%). Conclusion: EuroScore II, CKD, major transoperative bleeding, preoperative Hb and aPTT values and CPB time were independent predictors of transfusion, which was associated with a higher rate of adverse outcomes, including early mortality. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472019000600565 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472019000600565 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.5935/2359-4802.20190040 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia |
dc.source.none.fl_str_mv |
International Journal of Cardiovascular Sciences v.32 n.6 2019 reponame:International Journal of Cardiovascular Sciences (Online) instname:Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
instname_str |
Sociedade Brasileira de Cardiologia (SBC) |
instacron_str |
SBC |
institution |
SBC |
reponame_str |
International Journal of Cardiovascular Sciences (Online) |
collection |
International Journal of Cardiovascular Sciences (Online) |
repository.name.fl_str_mv |
International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC) |
repository.mail.fl_str_mv |
tailanerodrigues@cardiol.br||revistaijcs@cardiol.br |
_version_ |
1754732626073092096 |