Essen, B.J. van (Bart) (2018) Perioperative PRBC transfusion is not associated with increased 30-day mortality in cardiac surgery patients. thesis, Medicine.
Full text available on request.Abstract
Introduction: Cardiac surgery has the highest rate of packed red blood cell transfusion (PRBC) when compared to other types of surgery. Controversy exists about potential deleterious effects of perioperative PRBC transfusion and its effect on mortality and morbidity. The aim of this study was to investigate the effect of perioperative PRBC transfusion on postoperative mortality within 30 days in patients undergoing cardiac surgery. Material and methods: This observational, retrospective cohort study included 2034 patients undergoing on-pump coronary artery bypass grafting (CABG), aortic valve replacement (AVR) or AVR and CABG combined in the St. Antonius Hospital Nieuwegein, between January 2015 and December 2016. Primary endpoint was postoperative mortality up to 30 days. Univariable and multivariable logistic regression analyses were used to examine the association between PRBC transfusion and mortality. Secondary outcomes were mortality within 90 days, postoperative myocardial infarction, cerebrovascular accidents (CVA), surgical site infection and surgical re-exploration. A sensitivity analysis excluding all patients that received more than 5 units of PRBC, was also performed. Results: After adjusting for possible confounders, no statistical difference was found between 30-day mortality and PRBC transfusion (OR 1.74; 95%CI 0.60 – 5.07; p = 0.31). In contrary, 90-day mortality was associated with PRBC transfusion (OR 2.69; 95%CI 1.09 – 6.63; p = 0.03). However, after sensitivity analysis, this association was no longer significant (OR 2.55; 95%CI 0.97 – 6.69; p = 0.06). Conclusions: In this study, we found no association between perioperative PRBC transfusion and 30-day mortality. Identification of patient factors that are prognostic of transfusion outcome is warranted in optimization of transfusion practice.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Smit, Sytse Sicco MD |
| Supervisor name: | Coordinating supervisor: and Berg, Jur M. ten MD PhD and Daily supervisor: and Willemsen, Laura M. MD & PhD candidate Cardiology St. Antoni |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2398 |
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