Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study

Detalhes bibliográficos
Autor(a) principal: Tagliari,Ana Paula
Data de Publicação: 2019
Outros Autores: 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
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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spelling 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
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