Preoperative anemia versus blood transfusion: Which is the culprit for worse outcomes in cardiac surgery?

Journal of Thoracic and Cardiovascular Surgery

Volumn 156, Issue 1, 2018, Pages 66-74.e2

  LaPar, Damien J ^a   Hawkins, Robert B ^a   McMurry, Timothy L ^a   Isbell, James M ^a   Rich, Jeffrey B ^b   Speir, Alan M ^c   Quader, Mohammed A ^d   Kron, Irving L ^a   Kern, John A ^a   Ailawadi, Gorav ^a  

^a UNIVERSITY OF VIRGINIA   (United States)

^b SENTARA HEART HOSPITAL   (United States)

^c INOVA HEART AND VASCULAR INSTITUTE   (United States)

^d VIRGINIA COMMONWEALTH UNIVERSITY   (United States)

Author keywords

anemia; CABG; cardiac; hematocrit; transfusion

Indexed keywords

ADULT; AGED; ANEMIA; AORTIC CLAMPING; ARTICLE; ARTIFICIAL VENTILATION; ATRIAL FIBRILLATION; BLOOD TRANSFUSION REACTION; CARDIOPULMONARY BYPASS; CEREBROVASCULAR ACCIDENT; COMPARATIVE STUDY; CORONARY ARTERY BYPASS GRAFT; ELECTIVE SURGERY; EMERGENCY SURGERY; ERYTHROCYTE TRANSFUSION; FEMALE; HEART ARREST; HEART SURGERY; HEMATOCRIT; HUMAN; INCIDENCE; KIDNEY FAILURE; MAJOR CLINICAL STUDY; MALE; MORBIDITY; MORTALITY RISK; MULTICENTER STUDY (TOPIC); OFF PUMP CORONARY SURGERY; OPERATION DURATION; OUTCOME ASSESSMENT; PNEUMONIA; POSTOPERATIVE COMPLICATION; POSTOPERATIVE PERIOD; PREOPERATIVE PERIOD; PRIORITY JOURNAL; RISK FACTOR; SURGICAL MORTALITY; ADVERSE EVENT; BLOOD; CLINICAL TRIAL; METABOLISM; MIDDLE AGED; MORTALITY; MULTICENTER STUDY; POSTOPERATIVE HEMORRHAGE; REGISTER; RISK ASSESSMENT; TIME FACTOR; TREATMENT OUTCOME;

BIOLOGICAL MARKER; HEMOGLOBIN;

AGED; ANEMIA; BIOMARKERS; CARDIAC SURGICAL PROCEDURES; ERYTHROCYTE TRANSFUSION; FEMALE; HEMATOCRIT; HEMOGLOBINS; HUMANS; MALE; MIDDLE AGED; POSTOPERATIVE HEMORRHAGE; REGISTRIES; RISK ASSESSMENT; RISK FACTORS; TIME FACTORS; TREATMENT OUTCOME;

EID: 85046156645     PISSN: 00225223     EISSN: 1097685X     Source Type: Journal    
DOI: 10.1016/j.jtcvs.2018.03.109     Document Type: Article

References (28)

1. Speiss, B.D., Transfusion and outcome in heart surgery. Ann Thorac Surg 74 (2002), 986–987.
2. Rogers, M.A., Blumberg, N., Saint, S., Langa, K.M., Nallamothu, B.K., Hospital variation in transfusion and infection after cardiac surgery: a cohort study. BMC Med, 7, 2009, 37.
3. Stover, E.P., Siegel, L.C., Parks, R., Levin, J., Body, S.C., Maddi, R., et al. Variability in transfusion practice for coronary artery bypass surgery persists despite national consensus guidelines: a 24-institution study. Institutions of the multicenter study of perioperative ischemia research group. Anesthesiology 88 (1998), 327–333.
4. Banbury, M.K., Brizzio, M.E., Rajeswaran, J., Lytle, B.W., Blackstone, E.H., Transfusion increases the risk of postoperative infection after cardiovascular surgery. J Am Coll Surg 202 (2006), 131–138.
5. Engoren, M.C., Habib, R.H., Zacharias, A., Schwann, T.A., Riordan, C.J., Durham, S.J., Effect of blood transfusion on long-term survival after cardiac operation. Ann Thorac Surg 74 (2002), 1180–1186.
6. Koch, C.G., Li, L., Duncan, A.I., Mihaljevic, T., Cosgrove, D.M., Loop, F.D., et al. Morbidity and mortality risk associated with red blood cell and blood-component transfusion in isolated coronary artery bypass grafting. Crit Care Med 34 (2006), 1608–1616.
7. Koch, C.G., Li, L., Duncan, A.I., Mihaljevic, T., Loop, F.D., Starr, N.J., et al. Transfusion in coronary artery bypass grafting is associated with reduced long-term survival. Ann Thorac Surg 81 (2006), 1650–1657.
8. Murphy, G.J., Reeves, B.C., Rogers, C.A., Rizvi, S.I., Culliford, L., Angelini, G.D., Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation 116 (2007), 2544–2552.
9. Scott, B.H., Seifert, F.C., Grimson, R., Blood transfusion is associated with increased resource utilisation, morbidity and mortality in cardiac surgery. Ann Card Anaesth 11 (2008), 15–19.
10. Surgenor, S.D., DeFoe, G.R., Fillinger, M.P., Likosky, D.S., Groom, R.C., Clark, C., et al. Intraoperative red blood cell transfusion during coronary artery bypass graft surgery increases the risk of postoperative low-output heart failure. Circulation 114:1 Suppl (2006), I43–I48.
11. Surgenor, S.D., Kramer, R.S., Olmstead, E.M., Ross, C.S., Sellke, F.W., Likosky, D.S., et al. The association of perioperative red blood cell transfusions and decreased long-term survival after cardiac surgery. Anesth Analg 108 (2009), 1741–1746.
12. Spiess, B.D., Blood transfusion: the silent epidemic. Ann Thorac Surg 72 (2001), S1832–S1837.
13. Taylor, R.W., O'Brien, J., Trottier, S.J., Manganaro, L., Cytron, M., Lesko, M.F., et al. Red blood cell transfusions and nosocomial infections in critically ill patients. Crit Care Med 34 (2006), 2302–2308 quiz 2309.
14. Toy, P., Lowell, C., TRALI: definition, mechanisms, incidence and clinical relevance. Best Pract Res Clin Anaesthesiol 21 (2007), 183–193.
15. Koch, C.G., Khandwala, F., Li, L., Estafanous, F.G., Loop, F.D., Blackstone, E.H., Persistent effect of red cell transfusion on health-related quality of life after cardiac surgery. Ann Thorac Surg 82 (2006), 13–20.
16. Society of Thoracic Surgeons. Executive summary 2012. Available at: http://www.sts.org/sts-national-database/database-managers/executive-summaries. Accessed: May 5, 2014.
17. Hung, M., Besser, M., Sharples, L.D., Nair, S.K., Klein, A.A., The prevalence and association with transfusion, intensive care unit stay and mortality of pre-operative anaemia in a cohort of cardiac surgery patients. Anaesthesia 66 (2011), 812–818.
18. Karkouti, K., Wijeysundera, D.N., Beattie, W.S., Reducing Bleeding in Cardiac Surgery I. Risk associated with preoperative anemia in cardiac surgery: a multicenter cohort study. Circulation 117 (2008), 478–484.
19. Kulier, A., Levin, J., Moser, R., Rumpold-Seitlinger, G., Tudor, I.C., Snyder-Ramos, S.A., et al. Impact of preoperative anemia on outcome in patients undergoing coronary artery bypass graft surgery. Circulation 116 (2007), 471–479.
20. van Straten, A.H., Hamad, M.A., van Zundert, A.J., Martens, E.J., Schonberger, J.P., de Wolf, A.M., Preoperative hemoglobin level as a predictor of survival after coronary artery bypass grafting: a comparison with the matched general population. Circulation 120 (2009), 118–125.
21. DeFoe, G.R., Ross, C.S., Olmstead, E.M., Surgenor, S.D., Fillinger, M.P., Groom, R.C., et al. Lowest hematocrit on bypass and adverse outcomes associated with coronary artery bypass grafting. Northern New England cardiovascular disease study group. Ann Thorac Surg 71 (2001), 769–776.
22. Karkouti, K., Djaiani, G., Borger, M.A., Beattie, W.S., Fedorko, L., Wijeysundera, D., et al. Low hematocrit during cardiopulmonary bypass is associated with increased risk of perioperative stroke in cardiac surgery. Ann Thorac Surg 80 (2005), 1381–1387.
23. Loor, G., Li, L., Sabik, J.F. III, Rajeswaran, J., Blackstone, E.H., Koch, C.G., Nadir hematocrit during cardiopulmonary bypass: end-organ dysfunction and mortality. J Thorac Cardiovasc Surg 144 (2012), 654–662.
24. Kuduvalli, M., Oo, A.Y., Newall, N., Grayson, A.D., Jackson, M., Desmond, M.J., et al. Effect of peri-operative red blood cell transfusion on 30-day and 1-year mortality following coronary artery bypass surgery. Eur J Cardiothorac Surg 27 (2005), 592–598.
25. LaPar, D.J., Crosby, I.K., Ailawadi, G., Ad, N., Choi, E., Spiess, B.D., et al. Blood product conservation is associated with improved outcomes and reduced costs after cardiac surgery. J Thorac Cardiovasc Surg 145 (2013), 796–803 discussion 803-4.
26. van Straten, A.H., Bekker, M.W., Soliman Hamad, M.A., van Zundert, A.A., Martens, E.J., Schonberger, J.P., et al. Transfusion of red blood cells: the impact on short-term and long-term survival after coronary artery bypass grafting, a ten-year follow-up. Interact Cardiovasc Thorac Surg 10 (2010), 37–42.
27. Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Ferraris, V.A., Ferraris, S.P., Saha, S.P., Hessel, E.A. II, Haan, C.K., et al. 2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg 91 (2011), 944–982.
28. Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Ferraris, V.A., Ferraris, S.P., Saha, S.P., Hessel, E.A. II, Haan, C.K., et al. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists clinical practice guideline. Ann Thorac Surg 83:5 Suppl (2007), S27–S86.