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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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Estimated probability of death at 1 year of follow up with the number of units ofPRBCs
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f03: Estimated probability of death at 1 year of follow up with the number of units ofPRBCs

Mentions: Figure 3 shows a curve which estimates thelikelihood of death occurrence through the number of PRBCs units transfused. It is notedthat the estimated probability of death within one year from the CABG increasesprogressively according to the amount of allogeneic blood transfusion, so that, wheneight units of PRBCs are transfused the patient's probability of death is 50%, and withthe transfusion of 25 units of PBRCs the possibility of death is 100%.


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)

Estimated probability of death at 1 year of follow up with the number of units ofPRBCs
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f03: Estimated probability of death at 1 year of follow up with the number of units ofPRBCs
Mentions: Figure 3 shows a curve which estimates thelikelihood of death occurrence through the number of PRBCs units transfused. It is notedthat the estimated probability of death within one year from the CABG increasesprogressively according to the amount of allogeneic blood transfusion, so that, wheneight units of PRBCs are transfused the patient's probability of death is 50%, and withthe transfusion of 25 units of PBRCs the possibility of death is 100%.

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