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Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft.

Santos AA, Sousa AG, Piotto RF, Pedroso JC - Rev Bras Cir Cardiovasc (2013 Oct-Dec)

Bottom Line: The increasing number of allogeneic packed red blood cells transfused results in an increasing risk of mortality, highlighting a dose-dependent relation.The greater the amount of allogeneic blood transfused the greater the risk of mortality.The current transfusion practice needs to be reevaluated.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Transfusions of one or more packed red blood cells is a widely strategy used in cardiac surgery, even after several evidences of increased morbidity and mortality. The world's blood shortage is also already evident.

Objective: To assess whether the risk of mortality is dose-dependent on the number of packed red blood cells transfused after coronary artery bypass graft.

Methods: Between June 2009 and July 2010, were analyzed 3010 patients: transfused and non-transfused. Transfused patients were divided into six groups according to the number of packed red blood cells received: one, two, three, four, five, six or more units, then we assess the mortality risk in each group after a year of coronary artery bypass graft. To calculate the odds ratio was used the multivariate logistic regression model.

Results: The increasing number of allogeneic packed red blood cells transfused results in an increasing risk of mortality, highlighting a dose-dependent relation. The odds ratio values increase with the increased number of packed red blood cells transfused. The death's gross odds ratio was 1.42 (P=0.165), 1.94 (P=0.005), 4.17; 4.22, 8.70, 33.33 (P<0.001) and the adjusted death's odds ratio was 1.22 (P=0.43), 1.52 (P=0.08); 2.85; 2.86; 4.91 and 17.61 (P<0.001), as they received one, two, three, four, five, six or more packed red blood cells, respectively.

Conclusion: The mortality risk is directly proportional to the number of packed red blood cells transfused in coronary artery bypass graft. The greater the amount of allogeneic blood transfused the greater the risk of mortality. The current transfusion practice needs to be reevaluated.

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Univariate relationship between units of transfused PRBCs and subsequent 1 yearmortality. PRBCs – packed red blood cells; CI – confidence interval; *probability’s descriptive level of the logistic regression model
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f02: Univariate relationship between units of transfused PRBCs and subsequent 1 yearmortality. PRBCs – packed red blood cells; CI – confidence interval; *probability’s descriptive level of the logistic regression model

Mentions: Through a logistic regression model, the odds ratio (OR) value wasestimated for each one of the values of PRBCs units transfused in the univariateanalysis. The risk of mortality progressively increases according to the number ofpacked red blood cells transfused in the patient. As shown in Figure 2, with a single unit of PRBCs transfused there is an adverseclinical outcome with a greater risk of mortality (OR 1.42; P=0.165).For the group that received two units of packed red blood cells, the risk of mortalitywas significantly greater with an odds ratio of 1.94(P=0.005). The relationship between the risk of mortality and thenumber of units of allogeneic blood transfused becomes more evident when we analyze theother groups: Group C odds ratio of 4.17 (P<0.001);Group D odds ratio of 4.22 (P<0.001); Group Eodds ratio of 8.70 (P<0.001); and finally, inthe group that had received six or more units of packed red blood cells, we have a hugerisk of mortality showing an odds ratio of 33.33(P<0.001).


Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft.

Santos AA, Sousa AG, Piotto RF, Pedroso JC - Rev Bras Cir Cardiovasc (2013 Oct-Dec)

Univariate relationship between units of transfused PRBCs and subsequent 1 yearmortality. PRBCs – packed red blood cells; CI – confidence interval; *probability’s descriptive level of the logistic regression model
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4389431&req=5

f02: Univariate relationship between units of transfused PRBCs and subsequent 1 yearmortality. PRBCs – packed red blood cells; CI – confidence interval; *probability’s descriptive level of the logistic regression model
Mentions: Through a logistic regression model, the odds ratio (OR) value wasestimated for each one of the values of PRBCs units transfused in the univariateanalysis. The risk of mortality progressively increases according to the number ofpacked red blood cells transfused in the patient. As shown in Figure 2, with a single unit of PRBCs transfused there is an adverseclinical outcome with a greater risk of mortality (OR 1.42; P=0.165).For the group that received two units of packed red blood cells, the risk of mortalitywas significantly greater with an odds ratio of 1.94(P=0.005). The relationship between the risk of mortality and thenumber of units of allogeneic blood transfused becomes more evident when we analyze theother groups: Group C odds ratio of 4.17 (P<0.001);Group D odds ratio of 4.22 (P<0.001); Group Eodds ratio of 8.70 (P<0.001); and finally, inthe group that had received six or more units of packed red blood cells, we have a hugerisk of mortality showing an odds ratio of 33.33(P<0.001).

Bottom Line: The increasing number of allogeneic packed red blood cells transfused results in an increasing risk of mortality, highlighting a dose-dependent relation.The greater the amount of allogeneic blood transfused the greater the risk of mortality.The current transfusion practice needs to be reevaluated.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Transfusions of one or more packed red blood cells is a widely strategy used in cardiac surgery, even after several evidences of increased morbidity and mortality. The world's blood shortage is also already evident.

Objective: To assess whether the risk of mortality is dose-dependent on the number of packed red blood cells transfused after coronary artery bypass graft.

Methods: Between June 2009 and July 2010, were analyzed 3010 patients: transfused and non-transfused. Transfused patients were divided into six groups according to the number of packed red blood cells received: one, two, three, four, five, six or more units, then we assess the mortality risk in each group after a year of coronary artery bypass graft. To calculate the odds ratio was used the multivariate logistic regression model.

Results: The increasing number of allogeneic packed red blood cells transfused results in an increasing risk of mortality, highlighting a dose-dependent relation. The odds ratio values increase with the increased number of packed red blood cells transfused. The death's gross odds ratio was 1.42 (P=0.165), 1.94 (P=0.005), 4.17; 4.22, 8.70, 33.33 (P<0.001) and the adjusted death's odds ratio was 1.22 (P=0.43), 1.52 (P=0.08); 2.85; 2.86; 4.91 and 17.61 (P<0.001), as they received one, two, three, four, five, six or more packed red blood cells, respectively.

Conclusion: The mortality risk is directly proportional to the number of packed red blood cells transfused in coronary artery bypass graft. The greater the amount of allogeneic blood transfused the greater the risk of mortality. The current transfusion practice needs to be reevaluated.

Show MeSH
Related in: MedlinePlus