Volume 2 Issue 2

Research Article: Analysis of the Adult Cardiac Surgery Audit on Blood use in a Tertiary Hospital Prior to the Implementation of a Blood Program

Azucena Pajares1*, Ana Tur1, Iratxe Zarragoikoetxea1, Rosario Vicente1, Ignacio Moreno1, Rosa Aparicio1, Pablo Herrera1, Ana-Isabel Aleixandre1, Carmen de la Fuente1, Agustin Soria1, Francisco Ibanez1, Jose-Maria Loro1, Faisa Osseyran1, Joan Porta1, Pilar Argente1, Luis Larrea2

Objective: To analyse the exposure to allogeneic blood transfusion perioperatively in adult patients undergoing cardiac surgery.
Design: Retrospective cohort study of prospectively collected data.
Setting: Data was collected from consecutive adult patients who underwent cardiac surgery in a single university hospital between January 2013 and July 2013.
Participants: Data of 171 patients was collected from hospital records.
Interventions: None.
Measurements and Main Results: 89.5% of patients received a Blood Component (BC), all the non-transfused patients were men. The average RCC, FFP and PP transfused units per patient was 4.04; 1.02 and 1.12 respectively. Women received more RCC (5.07) than men (3.54). RCC transfused patients had lower height and preoperative haemoglobin; urea levels, Apache II score and EuroSCORE were higher and left ventricular ejection fraction was worse. A TRUST score higher than 2 predicted RCC transfusion. CPB mean time was higher and redo surgery was more common if transfused. RCC transfusion was associated with longer hospital and Critical Care Unit stay. Non-transfused patients had higher nadir (9.48 vs 7.42), post-surgery (10.50 vs 9.42) and hospital discharge (11.22 g/dL vs 10.34) haemoglobin levels. By multivariate regression, predictors of blood transfusion were CPB nadir haemoglobin, preoperative haemoglobin, and transfused plasma units. Patients who survived received fewer RCC units. At hospital discharge 94.5% of patients were anaemic. Anaemic patients were more transfused than non-anaemic patients (5.37 vs 3.28).
Conclusions: We found a high perioperative use of BC in cardiac surgery in our hospital, supporting the implementation of interdisciplinary protocols to reduce their use.
Keywords: Transfusion rate; Blood saving program; Anaemia; Cardiac surgery; Audit; Red blood cell transfusion

Cite this Article: Pajares A, Tur A, Zarragoikoetxea I, Vicente R, Moreno I, et al. Analysis of the Adult Cardiac Surgery Audit on Blood use in a Tertiary Hospital Prior to the Implementation of a Blood Program. Int J Clin Cardiol Res. 2018;2(2): 027-038

Published: 23 May 2018

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