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Updated: Aug 14, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Platelet Transfusion After Cardiac Surgery
Calvin M Fletcher1, Jake V Hinton2, Zhongyue Xing2
1Department of Anaesthesiology and Perioperative Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.
Insights
Platelet transfusions in cardiac surgery patients did not increase hospital mortality. However, they were linked to fewer infections and shorter intensive care unit (ICU) and hospital stays.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
- Critical Care Medicine
Background:
- Platelet transfusion is common in cardiac surgery.
- Its association with clinical outcomes requires further investigation.
Purpose of the Study:
- To examine the independent association of platelet transfusion with hospital mortality and clinical outcomes in adult cardiac surgery patients.
Main Methods:
- Retrospective, propensity score-matched cohort study.
- Included adult patients undergoing coronary artery bypass graft and/or valvular surgery.
- Analyzed data from 2001-2019 using the MIMIC III and IV databases.
Main Results:
- 1,621 of 12,043 patients received platelet transfusions.
- No association found between platelet transfusion and in-hospital mortality (OR: 1.28; 99% CI: 0.49-3.35).
- Associated with decreased odds of suspected infection (OR: 0.70; 99% CI: 0.50-0.97) and shorter ICU/hospital stays.
Conclusions:
- Perioperative platelet transfusion in cardiac surgery is not linked to increased hospital mortality.
- Platelet transfusion may reduce the risk of suspected infections.
- Associated with reduced length of stay in the ICU and hospital.
Objectives:
To investigate the independent association of platelet transfusion with hospital mortality and key relevant clinical outcomes in cardiac surgery.
Design:
A single-center, propensity score-matched, retrospective, cohort study.
Setting:
At an American tertiary teaching hospital data from the Medical Information Mart for Intensive Care III and IV databases from 2001 to 2019.
Participants:
Consecutive adults undergoing coronary artery bypass graft and/or cardiac valvular surgery.
Interventions:
Platelet transfusion during perioperative intensive care unit (ICU) admission.
Measurements And Main Results:
Overall, 12,043 adults met the study inclusion criteria. Of these, 1,621 (13.5%) received apheresis-leukoreduced platelets, with a median of 1.19 units per recipient (IQR: 0.93-1.19) at a median of 1.78 hours (IQR: 0.75-4.25) after ICU admission. The platelet count was measured in 1,176 patients (72.5%) before transfusion, with a median count of 120 × 109/L (IQR: 89.0-157.0), and only 53 (3.3%) had platelet counts below 50 × 109/L. After propensity matching of 1,046 platelet recipients with 1,046 controls, perioperative platelet transfusion carried no association with in-hospital mortality (odds ratio [OR]: 1.28; 99% CI: 0.49-3.35; p = 0.4980). However, it was associated with a pattern of decreased odds of suspected infection (eg, respiratory infection, urinary tract infection, septicaemia, or other; OR: 0.70; 99% CI: 0.50-0.97; p = 0.0050), days in the hospital (adjusted mean difference [AMD]: 0.86; 99% CI: -0.27 to 1.98; p = 0.048), or days in intensive care (AMD 0.83; 99% CI: -0.15 to 1.82; p = 0.0290).
Conclusions:
Platelet transfusion was not associated with hospital mortality, but it was associated with decreased odds of suspected infection and with shorter ICU and hospital stays.
