Anemia and Transfusion in Cardiac Surgery: A Retrospective Single-Centre Experience
Quynh Nguyen, Eric Meng, Joel Berube, Richard Bergstrom, Wing Lam
University of Alberta, Edmonton, AB, Canada
OBJECTIVE: Preoperative anemia correlates with an increased need for blood transfusion in cardiac surgery patients. Anemia and transfusion, individually and in tandem, are associated with worse outcomes. This study aims to identify the prevalence of preoperative anemia, red blood cell transfusion rates on surgery day, and factors predictive of transfusion in anemic patients undergoing elective cardiac surgery at our institution.
METHODS: This study included 797 adult patients who underwent elective cardiac surgery at a tertiary hospital. Multivariable regression analysis was used to identify predictive factors of transfusion on surgery day among preoperative anemic patients.
RESULTS: Preoperative anemia was present in 15% of our patients. Anemic patients tend to be female, older in age, have lower body weight and smaller body surface area. Compared to non-anemic patients, they were more likely to have diabetes, a history of cerebrovascular accident, poor kidney function and a reduced left ventricle ejection fraction. Anemic patients had a significantly higher transfusion rate at 53% compared to 10% in non-anemic patients. Anemic patients also had longer cardiovascular intensive care unit stays, longer hospital stays, and higher incidences of in-hospital mortality compared to non-anemic patients. Repeat sternotomy was predictive of transfusion on surgery day in preoperative anemic patients.
CONCLUSIONS: Preoperative anemia is common in our elective cardiac surgery patients. Anemic patients have high transfusion rates on surgery day and worse outcomes compared to non-anemic patients. Revision surgery with repeat sternotomy is a predictor of transfusion on surgery day in preoperative anemic patients who undergo elective cardiac surgery.
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