Eastern Cardiothoracic Surgical Society

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Asian Patients Require More Blood Transfusions in Cardiac Surgery: A Propensity-Matched Analysis
Takuya Ogami1, Eric Zimmermann1, Roger Zhu1, Anthony Lamonica2, John Petrie2, Charles Mack2, Samuel Lang2, Dimitrios Avgerinos2.
1New York-Presbyterian/Queens, Flushing, NY, USA, 2Weill Cornell Medicine, New York-Presbyterian, New York, NY, USA.

OBJECTIVE: Previous studies suggest Asian patients have a higher incidence of bleeding. The aim of this study is to examine bleeding tendencies in Asian patient populations undergoing cardiac surgery.
METHODS: Consecutive patients undergoing cardiac surgery at our hospital between January 2016 and March 2017 were studied. Patients were divided into groups by race, Asian and non-Asian, for analysis. Propensity score matching was applied to adjust for differences in baseline. Multivariable analysis was performed to determine clinicopathological associations relating to the number and quantity of transfusions, which were used as surrogate end points for bleeding risk.
RESULTS: 244 patients records were available for analysis. Propensity score matching yielded 92 matched pairs (Asian vs non-Asian) for evaluation. Analysis revealed a significantly greater volume of intraoperative transfusions in Asian patients (0.96 vs 0.46 units, P=0.04). Multivariable analysis revealed age > 65, male gender, chronic kidney disease, and preoperative hematocrit > 40 as well as Asian race were independently associated with intraoperative transfusions.
CONCLUSIONS: The volume of blood required intraoperatively was greater in Asian patient as compared to non-Asian patient who underwent cardiac surgery. Our study suggests Asian patients may have a higher bleeding risk when undergoing cardiac surgery as compared to patients of other races.

Multivariable analysis for intraoperative transfusion
VariableOR (95%CI)p-value
Age > 65 years3.26 (1.40-7.60)0.006
Male6.35 (2.67-15.1)<0.001
Asian2.82 (1.20-6.62)0.02
Preoperative hematocrit > 40 %0.275 (0.10-0.74)0.01
Chronic Kidney disease5.22 (1.17-23.4)0.03


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