Effects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland – a retrospective cohort study
Background: Packed red blood cell (pRBC) transfusion is a relatively safe and mainstay treatment commonly used in cardiac surgical patients. However, there is limited evidence on clinical effects of transfusing blood nearing end-of shelf life that has undergone biochemical changes during storage. Ob...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
BioMed Central
2024
|
| _version_ | 1811140374614245376 |
|---|---|
| author | Obonyo, NG Dhanapathy, V White, N Sela, DP Rachakonda, RH Tunbridge, M Sim, B Teo, D Nadeem, Z See Hoe, LE Bassi, GL Fanning, JP Tung, J Suen, JY Fraser, JF |
| author_facet | Obonyo, NG Dhanapathy, V White, N Sela, DP Rachakonda, RH Tunbridge, M Sim, B Teo, D Nadeem, Z See Hoe, LE Bassi, GL Fanning, JP Tung, J Suen, JY Fraser, JF |
| author_sort | Obonyo, NG |
| collection | OXFORD |
| description | Background: Packed red blood cell (pRBC) transfusion is a relatively safe and mainstay treatment commonly used in cardiac surgical patients. However, there is limited evidence on clinical effects of transfusing blood nearing end-of shelf life that has undergone biochemical changes during storage. Objective: To investigate evidence of associations between morbidity/mortality and transfusion of blood near end of shelf-life (> 35 days) in cardiac surgical patients. Methods: Data from the Queensland Health Admitted Patient Data Collection database 2007–2013 was retrospectively analysed. Coronary artery bypass graft and valvular repair patients were included. Multivariable logistic regression was used to examine the effect of pRBC age (< 35 days vs. ≥ 35 days) on in-hospital mortality and morbidity. As secondary analysis, outcomes associated with the number of pRBC units transfused (≤ 4 units vs. ≥ 5 units) were also assessed. Results: A total of 4514 cardiac surgery patients received pRBC transfusion. Of these, 292 (6.5%) received pRBCs ≥ 35 days. No difference in in-hospital mortality or frequency of complications was observed. Transfusion of ≥ 5 units of pRBCs compared to the ≤ 4 units was associated with higher rates of in-hospital mortality (5.6% vs. 1.3%), acute renal failure (17.6% vs. 8%), infection (10% vs. 3.4%), and acute myocardial infarction (9.2% vs. 4.3%). Infection carried an odds ratio of 1.37 between groups (CI = 0.9–2.09; p = 0.14) and stroke/neurological complications, 1.59 (CI = 0.96–2.63; p = 0.07). Conclusion: In cardiac surgery patients, transfusion of pRBCs closer to end of shelf-life was not shown to be associated with significantly increased mortality or morbidity. Dose-dependent differences in adverse outcomes (particularly where units transfused were > 4) were supported. |
| first_indexed | 2024-09-25T04:20:58Z |
| format | Journal article |
| id | oxford-uuid:b61b88fa-211c-447c-8d7d-a8d66658e289 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:20:58Z |
| publishDate | 2024 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:b61b88fa-211c-447c-8d7d-a8d66658e2892024-08-01T19:36:09ZEffects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland – a retrospective cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b61b88fa-211c-447c-8d7d-a8d66658e289EnglishJisc Publications RouterBioMed Central2024Obonyo, NGDhanapathy, VWhite, NSela, DPRachakonda, RHTunbridge, MSim, BTeo, DNadeem, ZSee Hoe, LEBassi, GLFanning, JPTung, JSuen, JYFraser, JFBackground: Packed red blood cell (pRBC) transfusion is a relatively safe and mainstay treatment commonly used in cardiac surgical patients. However, there is limited evidence on clinical effects of transfusing blood nearing end-of shelf life that has undergone biochemical changes during storage. Objective: To investigate evidence of associations between morbidity/mortality and transfusion of blood near end of shelf-life (> 35 days) in cardiac surgical patients. Methods: Data from the Queensland Health Admitted Patient Data Collection database 2007–2013 was retrospectively analysed. Coronary artery bypass graft and valvular repair patients were included. Multivariable logistic regression was used to examine the effect of pRBC age (< 35 days vs. ≥ 35 days) on in-hospital mortality and morbidity. As secondary analysis, outcomes associated with the number of pRBC units transfused (≤ 4 units vs. ≥ 5 units) were also assessed. Results: A total of 4514 cardiac surgery patients received pRBC transfusion. Of these, 292 (6.5%) received pRBCs ≥ 35 days. No difference in in-hospital mortality or frequency of complications was observed. Transfusion of ≥ 5 units of pRBCs compared to the ≤ 4 units was associated with higher rates of in-hospital mortality (5.6% vs. 1.3%), acute renal failure (17.6% vs. 8%), infection (10% vs. 3.4%), and acute myocardial infarction (9.2% vs. 4.3%). Infection carried an odds ratio of 1.37 between groups (CI = 0.9–2.09; p = 0.14) and stroke/neurological complications, 1.59 (CI = 0.96–2.63; p = 0.07). Conclusion: In cardiac surgery patients, transfusion of pRBCs closer to end of shelf-life was not shown to be associated with significantly increased mortality or morbidity. Dose-dependent differences in adverse outcomes (particularly where units transfused were > 4) were supported. |
| spellingShingle | Obonyo, NG Dhanapathy, V White, N Sela, DP Rachakonda, RH Tunbridge, M Sim, B Teo, D Nadeem, Z See Hoe, LE Bassi, GL Fanning, JP Tung, J Suen, JY Fraser, JF Effects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland – a retrospective cohort study |
| title | Effects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland – a retrospective cohort study |
| title_full | Effects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland – a retrospective cohort study |
| title_fullStr | Effects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland – a retrospective cohort study |
| title_full_unstemmed | Effects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland – a retrospective cohort study |
| title_short | Effects of red blood cell transfusion on patients undergoing cardiac surgery in Queensland – a retrospective cohort study |
| title_sort | effects of red blood cell transfusion on patients undergoing cardiac surgery in queensland a retrospective cohort study |
| work_keys_str_mv | AT obonyong effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT dhanapathyv effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT whiten effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT seladp effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT rachakondarh effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT tunbridgem effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT simb effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT teod effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT nadeemz effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT seehoele effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT bassigl effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT fanningjp effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT tungj effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT suenjy effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy AT fraserjf effectsofredbloodcelltransfusiononpatientsundergoingcardiacsurgeryinqueenslandaretrospectivecohortstudy |