Anemia in Cardiac Surgery - Can Something Bad Get Worse?
Abstract Introduction: Anemia and blood transfusion are risk factors for morbidity/mortality in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The objective of this study is to analyze the association of blood transfusion with morbidity/mortality in patients undergoing coronary artery bypass grafting (CABG) under CPB in the state of São Paulo, Brazil. Methods: This is a retrospective analysis using the State of São Paulo Registry of Cardiovascular Surgery from November 2013 to August 2014. Blood transfusion was only considered during surgery or within six hours after surgery. Anemia was defined as hematocrit ≤ 37.5%. Patients < 18 years old were excluded. The sample was divided in four groups - Group I (851, no anemia), Group II (200, anemia without blood transfusion), Group III (181, no anemia and transfusion), and Group IV (258, anemia and transfusion). Results: A total of 1,490 patients were included; 639 (42.9%) were anemic and 439 (29.5%) underwent blood transfusion. Group II showed lower composite morbidity (odds ratio [OR] −0.05; confidence interval [CI] −0.27-0.17; P=0.81) than Group III (OR 0.41; CI 0.23-0.59; P=0.018) or Group IV (OR 0.54; CI 0.31-0.77; P=0.016). Group III was at greater risk of mortality (OR 0.73; CI 0.43-1.03; P=0.02) than Group II, which was exposed only to anemia (OR −0.13; CI −0.55-0.29; P=0.75), or Group IV (OR 0.29; CI −0.13-0.71; P=0.539). Conclusion: Anemia in patients undergoing CABG with CPB is bad, but blood transfusion can be worse, increasing at least 50% the risk for mortality and/or morbidity.
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Sociedade Brasileira de Cirurgia Cardiovascular
2021
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oai:scielo:S0102-763820210002001652021-05-05Anemia in Cardiac Surgery - Can Something Bad Get Worse?Faria,Leandro Batisti deMejia,Omar VilcaMiana,Leonardo AugustoLisboa,Luiz Augusto FerreiraManuel,ValdanoJatene,Marcelo B.Jatene,Fabio B. Anemia Cardiac Surgical Procedures Blood Transfusion Hematocrit Cardiopulmonary Bypass Risk Factors Abstract Introduction: Anemia and blood transfusion are risk factors for morbidity/mortality in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The objective of this study is to analyze the association of blood transfusion with morbidity/mortality in patients undergoing coronary artery bypass grafting (CABG) under CPB in the state of São Paulo, Brazil. Methods: This is a retrospective analysis using the State of São Paulo Registry of Cardiovascular Surgery from November 2013 to August 2014. Blood transfusion was only considered during surgery or within six hours after surgery. Anemia was defined as hematocrit ≤ 37.5%. Patients < 18 years old were excluded. The sample was divided in four groups - Group I (851, no anemia), Group II (200, anemia without blood transfusion), Group III (181, no anemia and transfusion), and Group IV (258, anemia and transfusion). Results: A total of 1,490 patients were included; 639 (42.9%) were anemic and 439 (29.5%) underwent blood transfusion. Group II showed lower composite morbidity (odds ratio [OR] −0.05; confidence interval [CI] −0.27-0.17; P=0.81) than Group III (OR 0.41; CI 0.23-0.59; P=0.018) or Group IV (OR 0.54; CI 0.31-0.77; P=0.016). Group III was at greater risk of mortality (OR 0.73; CI 0.43-1.03; P=0.02) than Group II, which was exposed only to anemia (OR −0.13; CI −0.55-0.29; P=0.75), or Group IV (OR 0.29; CI −0.13-0.71; P=0.539). Conclusion: Anemia in patients undergoing CABG with CPB is bad, but blood transfusion can be worse, increasing at least 50% the risk for mortality and/or morbidity.info:eu-repo/semantics/openAccessSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery v.36 n.2 20212021-04-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000200165en10.21470/1678-9741-2020-0304 |
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Faria,Leandro Batisti de Mejia,Omar Vilca Miana,Leonardo Augusto Lisboa,Luiz Augusto Ferreira Manuel,Valdano Jatene,Marcelo B. Jatene,Fabio B. |
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Faria,Leandro Batisti de Mejia,Omar Vilca Miana,Leonardo Augusto Lisboa,Luiz Augusto Ferreira Manuel,Valdano Jatene,Marcelo B. Jatene,Fabio B. Anemia in Cardiac Surgery - Can Something Bad Get Worse? |
author_facet |
Faria,Leandro Batisti de Mejia,Omar Vilca Miana,Leonardo Augusto Lisboa,Luiz Augusto Ferreira Manuel,Valdano Jatene,Marcelo B. Jatene,Fabio B. |
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Faria,Leandro Batisti de |
title |
Anemia in Cardiac Surgery - Can Something Bad Get Worse? |
title_short |
Anemia in Cardiac Surgery - Can Something Bad Get Worse? |
title_full |
Anemia in Cardiac Surgery - Can Something Bad Get Worse? |
title_fullStr |
Anemia in Cardiac Surgery - Can Something Bad Get Worse? |
title_full_unstemmed |
Anemia in Cardiac Surgery - Can Something Bad Get Worse? |
title_sort |
anemia in cardiac surgery - can something bad get worse? |
description |
Abstract Introduction: Anemia and blood transfusion are risk factors for morbidity/mortality in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The objective of this study is to analyze the association of blood transfusion with morbidity/mortality in patients undergoing coronary artery bypass grafting (CABG) under CPB in the state of São Paulo, Brazil. Methods: This is a retrospective analysis using the State of São Paulo Registry of Cardiovascular Surgery from November 2013 to August 2014. Blood transfusion was only considered during surgery or within six hours after surgery. Anemia was defined as hematocrit ≤ 37.5%. Patients < 18 years old were excluded. The sample was divided in four groups - Group I (851, no anemia), Group II (200, anemia without blood transfusion), Group III (181, no anemia and transfusion), and Group IV (258, anemia and transfusion). Results: A total of 1,490 patients were included; 639 (42.9%) were anemic and 439 (29.5%) underwent blood transfusion. Group II showed lower composite morbidity (odds ratio [OR] −0.05; confidence interval [CI] −0.27-0.17; P=0.81) than Group III (OR 0.41; CI 0.23-0.59; P=0.018) or Group IV (OR 0.54; CI 0.31-0.77; P=0.016). Group III was at greater risk of mortality (OR 0.73; CI 0.43-1.03; P=0.02) than Group II, which was exposed only to anemia (OR −0.13; CI −0.55-0.29; P=0.75), or Group IV (OR 0.29; CI −0.13-0.71; P=0.539). Conclusion: Anemia in patients undergoing CABG with CPB is bad, but blood transfusion can be worse, increasing at least 50% the risk for mortality and/or morbidity. |
publisher |
Sociedade Brasileira de Cirurgia Cardiovascular |
publishDate |
2021 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021000200165 |
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