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Association of Intraoperative Red Blood Cell Transfusions With Venous Thromboembolism and Adverse Outcomes After Cardiac Surgery.
Raphael, Jacob; Feng, Xiaoke; Shotwell, Matthew S; Mazzeffi, Michael A; Bollen, Bruce A; Shah, Ashish S; Kertai, Miklos D.
Afiliação
  • Raphael J; Department of Anesthesiology, Thomas Jefferson University Hospitals, Philadelphia, PA.
  • Feng X; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
  • Shotwell MS; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
  • Mazzeffi MA; Department of Anesthesiology and Critical Care Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.
  • Bollen BA; Missoula Anesthesiology PC, Missoula, MT.
  • Shah AS; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, TN.
  • Kertai MD; Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN.
Ann Surg ; 278(3): e650-e660, 2023 09 01.
Article em En | MEDLINE | ID: mdl-36538645
OBJECTIVE: We determined whether intraoperative packed red blood cell (PRBC) transfusion was associated with a higher incidence of hospital-acquired venous thromboembolic (HA-VTE) complications and adverse outcomes after isolated coronary artery bypass grafting (CABG) surgery. BACKGROUND: Intraoperative PRBC has been associated with increased risk for postoperative deep venous thrombosis after cardiac surgery, but validation of these findings in a large, multi-institutional, national cohort of cardiac surgery patients has been lacking. METHODS: A registry-based cohort study of 751,893 patients with isolated CABG between January 1, 2015, to December 31, 2019. Using propensity score-weighted regression analysis, we analyzed the effect of intraoperative PRBC on the incidence of HA-VTE and adverse outcomes. RESULTS: Administration of 1, 2, 3, and ≥4 units of PRBC transfusion was associated with increased odds for HA-VTE [odds ratios (ORs): 1.27 (1.22-1.32), 1.21 (1.16-1.26), 1.93 (1.85-2.00), 1.82 (1.75-1.89)], deep venous thrombosis [ORs: 1.39 (1.33-1.46), 1.38 (1.32-1.44), 2.18 (2.09-2.28), 1.82 (1.74-1.91], operative mortality [ORs: 1.11 (1.08-1.14), 1.16 (1.13-1.19), 1.29 (1.26-1.32), 1.47 (1.43-1.50)], readmission within 30 days [ORs: 1.05 (1.04-1.06), 1.16 (1.13-1.19), 1.29 (1.26-1.32), 1.47 (1.43-1.50)], and a prolonged postoperative length of stay [mean difference in days, 0.23 (0.19-0.27), 0.34 (0.30-0.39), 0.69 (0.64-0.74), 0.77 (0.72-0.820]. The odds of pulmonary venous thromboembolism were lower for patients transfused with 1 or 2 units [ORs: 0.98 (0.91-1.06), 0.75 (0.68-0.81)] of PRBC but remained significantly elevated for those receiving 3 and ≥4 units [ORs: 1.19 (1.09-1.29), 1.35 (1.25-1.48)]. CONCLUSIONS: Intraoperative PRBC transfusion was associated with HA-VTE and adverse outcomes after isolated CABG surgery.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trombose Venosa / Tromboembolia Venosa / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Ann Surg Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trombose Venosa / Tromboembolia Venosa / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Ann Surg Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos