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Predictors of blood transfusion in patients undergoing coronary artery bypass grafting surgery
Saleh Sandoughdaran1, Mahmood Reza Sarzaeem1, Jamshid Bagheri1
1Cardiac Surgery and Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Insights
Predictors for blood transfusion during coronary artery bypass grafting (CABG) include cardiopulmonary bypass use, lower preoperative hemoglobin, and female gender. These factors aid in preserving blood bank resources.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
Background:
- Blood transfusion is common in coronary artery bypass grafting (CABG).
- Identifying predictors of transfusion need is crucial for resource management and patient safety.
Purpose of the Study:
- To identify patient characteristics that predict the need for blood transfusion during CABG.
- To establish a clinical tool for optimizing blood bank resource utilization.
Main Methods:
- Retrospective study of 1835 patients undergoing CABG.
- Univariate and multivariate logistic regression analyses were used to identify risk factors for blood transfusion.
Main Results:
- Blood transfusion was required in 29.9% of patients.
- Independent predictors for transfusion included cardiopulmonary bypass (CPB) use, lower preoperative hemoglobin, and female gender.
- Female gender (OR: 2.29), CPB use (OR: 12.2), and hemoglobin (OR: 0.8) were significant predictors.
Conclusions:
- Cardiopulmonary bypass, preoperative hemoglobin levels, and female gender are key predictors of red blood cell (RBC) transfusion after isolated CABG.
- These findings can guide clinical practice to conserve blood bank resources without compromising patient safety.
Objectives:
The aim of this retrospective study is to identify intraoperative patient's characteristics predicting the need for blood transfusion during CABG in our local cardiac surgical service.
Methods:
This study included 1835 consecutive patients, 1311 males and 524 females with mean age 58.8±9.9 years, undergoing coronary artery bypass grafting. Risk factors detected by univariate study were entered in a multivariate logistic regression model of the relationship between preoperative variables and blood transfusion.
Results:
Blood transfusion was used in 435 patients (29.9%). Univariate analysis identified hemoglobin, smoking, hypertension, sex, diabetes, BMI and use of cardiopulmonary bypass (CPB) as significant predictors. Multivariate analysis revealed hemoglobin (OR: 0.8; CI: 0.74-0.86; P<0.001), CPB use (OR: 12.2; CI: 8.2-18.1; P<0.001) and female gender (OR: 2.29; CI:1.72-3.04; P<0.001) as independent risk factors for blood transfusion.
Conclusions:
The predictors of RBC transfusion after isolated CABG were performing CPB, preoperative hemoglobin and female gender. These factors can be used as a clinical tool to preserve blood bank resources without increasing patient's risk.
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