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Red blood cell transfusion is a determinant of neurological complications after cardiac surgery

Giovanni Mariscalco1, Fausto Biancari2, Tatu Juvonen2

  • 1Department of Heart and Vessels, Cardiac Surgery Unit, Varese University Hospital, Varese, Italy giovannimariscalco@yahoo.it.

Interactive Cardiovascular and Thoracic Surgery
|November 5, 2014
PubMed

Insights

Red blood cell (RBC) transfusions after cardiac surgery increase the risk of stroke and transient ischemic attack (TIA). Even transfusing more than two RBC units significantly elevates these risks, highlighting the need for careful transfusion management.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Transfusion Medicine

Background:

  • Cardiac surgery patients often require red blood cell (RBC) transfusions.
  • The association between RBC transfusions and postoperative neurological events like stroke and transient ischemic attack (TIA) requires further investigation.

Purpose of the Study:

  • To evaluate the impact of RBC transfusions on the incidence of stroke and TIA following cardiac surgery.
  • To determine if the amount of RBCs transfused correlates with the risk of these neurological events.

Main Methods:

  • A retrospective analysis of 14,956 patients undergoing coronary artery bypass grafting (CABG) and/or valve surgery at three European University Hospitals.
  • Logistic regression and multilevel propensity score analysis were employed to assess the prognostic impact of RBC transfusion on postoperative stroke and TIA.

Main Results:

  • RBC transfusion was identified as an independent predictor of postoperative stroke and TIA.
  • An increased number of transfused RBC units correlated with higher rates of stroke and TIA.
  • Transfusion of 6 or more RBC units was associated with a significantly elevated risk of stroke (3.9%) and TIA (5.9%).

Conclusions:

  • Transfusion of more than 2 units of RBCs after cardiac surgery is linked to a significantly increased risk of postoperative stroke and TIA.
  • These findings underscore the importance of judicious RBC transfusion strategies in cardiac surgery patients to mitigate neurological complications.
Abstract

Keywords:
Aortic valveBlood transfusionCardiac surgeryCoronary artery bypassMitral valveStrokeTransient ischaemic attack

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