The association of blood transfusion with mortality after cardiac surgery: cause or confounding? (CME)

Transfusion
Barry DixonDuncan J Campbell

Abstract

Bleeding into the chest is a life-threatening complication of cardiac surgery. Blood transfusion has been implicated as an important cause of harm associated with bleeding, based largely on studies demonstrating an independent association between transfusion and mortality. These studies did not, however, consider the possibility that bleeding may in itself be harmful, inasmuch as drains are inefficient at clearing blood from the chest and retained blood may compromise cardiac and lung function. We undertook a multivariate logistic regression analysis of the risk factors associated with mortality in 2599 consecutive patients undergoing cardiac surgery. Unlike previous studies the risk factors examined included the volume of chest tube drainage at 24 hours. A stratified analysis was also undertaken that compared the adjusted risk of death for patients exposed or not exposed to a postoperative blood transfusion. Blood transfusion was not an independent predictor of mortality (p=0.4). Chest tube drainage was the strongest independent predictor of mortality (p<0.001). In the stratified analysis, chest tube drainage remained an independent predictor of mortality for patients not exposed to a blood transfusion (p<0.01). Furthermore, t...Continue Reading

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Citations

Mar 23, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jamshid H KarimovKiyotaka Fukamachi
Jan 17, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ariane WillemsPhilippe Van der Linden
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Apr 23, 2021·Journal of Cardiothoracic Surgery·Mirna PetricevicBojan Biocina
Jul 31, 2019·The Thoracic and Cardiovascular Surgeon·Mate PetricevicKlaus Goerlinger

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