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Gender is Independently Associated With Red Blood Cell and Platelet Transfusion in Patients Undergoing Coronary
Mara-Louise Wester1, Fleur Sampon1, Jules R Olsthoorn1
1Department of Cardiothoracic Surgery, Catharina Hospital Eindhoven, Eindhoven, the Netherlands.
Insights
This study found that 27% of patients undergoing coronary artery bypass grafting (CABG) received blood transfusions. Women were more likely to receive red blood cell (RBC) transfusions after CABG compared to men.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
- Health Services Research
Background:
- Blood product transfusion is common following coronary artery bypass grafting (CABG).
- Understanding transfusion patterns and sex-based differences is crucial for optimizing patient care.
- The Netherlands Heart Registration (NHR) provides a robust dataset for such analyses.
Purpose of the Study:
- To determine the incidence of red blood cell (RBC), platelet, and fresh frozen plasma (FFP) transfusions during and after CABG in the Netherlands.
- To investigate the impact of patient sex on the likelihood and type of blood product transfusion post-CABG.
Main Methods:
- Retrospective multicenter cohort study utilizing data from the NHR database (2013-2021).
- Inclusion of adult patients (≥18 years) who underwent CABG (on-pump or off-pump).
- Analysis of transfusion incidence and types (RBC, platelets, FFP) and their association with sex.
Main Results:
- Overall transfusion incidence was 27.0% (11,428/42,388 patients).
- Women received RBC transfusions significantly more often than men (45.4% vs. 15.6%, p < 0.001).
- A significant difference in platelet transfusion rates was observed between sexes (10.0% vs. 11.1%, p = 0.005), but not for FFP.
Conclusions:
- The incidence of any blood transfusion post-CABG in the Netherlands is 27.0%.
- Female sex is independently associated with a higher likelihood of receiving RBC transfusions after CABG.
- These findings highlight sex-based disparities in transfusion practices following cardiac surgery.
Objectives:
The aim of this study was to evaluate the incidence of transfusions, including red blood cells (RBC), platelets, and fresh frozen plasma (FFP) during and after coronary artery bypass grafting (CABG) in the Netherlands. Furthermore, the authors aimed to identify the impact of sex on blood product transfusion.
Design:
A retrospective multicenter cohort study. Data were collected from January 2013 to December 2021 from the Netherlands Heart Registration (NHR) database.
Setting:
The NHR receives its data from 16 heart centers in the Netherlands.
Participants:
Patients older than 18 years who underwent CABG in the Netherlands.
Interventions:
Coronary artery bypass grafting with extracorporeal circulation or off-pump coronary artery bypass grafting.
Measurements And Main Results:
The incidence of blood transfusion, defined as transfusions intraoperatively and during the length of the hospital admission after CABG. In addition, a differentiation was made according to the type of transfusion (packed RBC, platelets, and FFP). In the overall cohort (N = 42,388), the number of patients who received a transfusion of any type was 27.0% (n = 11,428). Women received more often RBC transfusions compared with men (45.4% v 15.6%, respectively, p < 0.001). There was a significant difference between the 2 sexes regarding platelet transfusion (women 10.0% v men 11.1%, p = 0.005) but not in FFP transfusion. Female sex was independently associated with RBC transfusion, using the multivariate logistic regression analysis.
Conclusions:
The incidence of any blood transfusion was 27.0%, and was higher in women than in men. The female sex was independently associated with receiving RBC during and after CABG.
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