Related Experiment Video
Updated: Jan 1, 2026
Innovative Strategies for Organ Preservation in Heart Transplantation: Uniform Cooling Preservation and Ex-situ Normothermic Perfusion
Published on: November 28, 2025
Case Start Time Affects Intraoperative Transfusion Rates in Adult Cardiac Surgery: A Single-Center Retrospective
Dylan R Addis1, Blake A Moore2, Chandrika R Garner3
1Wake Forest School of Medicine, Department of Anesthesiology, Winston-Salem, NC; University of Alabama at Birmingham, Department of Anesthesiology and Perioperative Medicine, Division of Cardiothoracic Anesthesiology, Birmingham, AL.
Insights
Later surgery start times in cardiac procedures correlate with increased intraoperative red blood cell transfusions. This study highlights the impact of timing on transfusion probability in adult cardiac surgery patients.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Transfusion Medicine
Background:
- Perioperative outcomes can be influenced by various factors, including the timing of surgical procedures.
- Understanding temporal variations in patient management is crucial for optimizing surgical care.
Purpose of the Study:
- To investigate the association between the time of day and perioperative outcomes.
- Specifically, to examine intraoperative transfusion rates in adult cardiac surgery patients based on case start times.
Main Methods:
- Retrospective observational study conducted at a single academic medical center.
- Included adult patients undergoing cardiac surgery with cardiopulmonary bypass.
- Multivariate logistic regression was used to analyze the association between case start time and transfusion probability.
Main Results:
- A total of 1,421 cases were initially reviewed, with 1,220 matched for analysis.
- The probability of receiving an intraoperative red blood cell transfusion significantly increased with later case start times (p=0.027).
- No significant difference in transfusion probability was observed for plasma, cryoprecipitate, or platelets based on case start time.
Conclusions:
- The rate of intraoperative blood product transfusion varies significantly with later case start times in scheduled cardiac surgery.
- Timing of cardiac surgery may be a relevant factor influencing the need for red blood cell transfusions.
Objective:
The goal of the study was to investigate the role time of day plays in perioperative outcomes. The authors examined intraoperative transfusion rates throughout the day in adult cardiac surgery patients. They hypothesized that the rate of transfusion changes with later case start times in scheduled cardiac surgery.
Design:
Retrospective observational study.
Setting:
Single academic medical center.
Participants:
Adults undergoing cardiac surgery involving cardiopulmonary bypass.
Interventions:
None.
Measurements And Main Results:
The primary outcome was a composite variable of transfusion. The association between the time of day and the rate of transfusion was explored with a multivariate logistic regression to fit the effect of starting time as a cubic spline. There were 1,421 cases that met inclusion criteria. There were 1,220 cases that were matched for modeling. The estimated probability of a patient receiving a transfusion changed significantly with later case start times in the multivariable model after adjusting for initial hemoglobin, age, sex, height, ideal body weight, diabetes, peripheral vascular disease, stroke, chronic kidney disease, chronic obstructive pulmonary disease, duration of cardiopulmonary bypass, aortic cross clamp time, attending surgeon, and attending anesthesiologist (p = 0.032, C-statistic = 0.807, n = 1220). The estimated probability of receiving an intraoperative red blood cell transfusion increased with later case start times in the multivariable model (p = 0.027, C-statistic = 0.902, n = 1220). There was no difference in the probability of transfusion for plasma, cryoprecipitate, or platelets.
Conclusions:
The observed rate of intraoperative blood product transfusion changed with later case start times in a multivariable model of scheduled cardiac surgery.
More Related Videos
09:54Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
12:40A Modified Murine Heterotopic Heart Transplant Protocol Matching Contemporary Standards of Aseptic Technique, Anesthesia, and Analgesia
Published on: September 28, 2022
