The independent association of massive blood loss with mortality in cardiac surgery

Transfusion
Keyvan KarkoutiJ Karski

Abstract

Although the association between massive perioperative blood loss (MBL) and adverse outcomes is well recognized, it is unclear whether MBL is an independent risk factor or, instead, simply a marker for other adverse events or severity of illness. The objective of this cohort study was to quantify the independent association of MBL in cardiac surgery with all-cause in-hospital mortality. Data were prospectively collected on consecutive patients who underwent cardiac surgery with cardiopulmonary bypass at a quaternary-care academic center from 1999 to 2003. The number of red blood cell (RBC) units transfused within 1 day of surgery was used as a surrogate measure of perioperative blood loss. Receiver-operating characteristic curve analyses were employed to identify the most appropriate cutoff for defining MBL. The independent association of MBL with mortality was determined with multivariable logistic regression analyses. Bootstrapping and sensitivity analyses were used to confirm the validity of the results. MBL was defined as receiving at least 5 units of RBCs within 1 day of surgery. Of 9215 patients analyzed, 1.8 percent (n = 169) died and 9.7 percent (n = 890) had MBL. After adjusting for multiple potential confounders (incl...Continue Reading

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Citations

Apr 2, 2008·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Ravi GillPaul Diprose
Mar 11, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Keyvan KarkoutiW Scott Beattie
Jul 3, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Keyvan KarkoutiRichard I Hall
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Jul 29, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Keyvan KarkoutiW Scott Beattie

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