Thorac Cardiovasc Surg 2003; 51(1): 17-21
DOI: 10.1055/s-2003-37281
Original Cardiovascular
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Predictors of Homologous Blood Transfusion for Patients Undergoing Open Heart Surgery

J.  Litmathe1 , U.  Boeken1 , P.  Feindt1 , E.  Gams1
  • 1Department of Thoracic- and Cardiovascular Surgery, Heinrich-Heine-University, Düsseldorf
Presented in part at 31st Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery in Leipzig as oral publication.
Further Information

Publication History

Received August 18, 2002

Publication Date:
14 February 2003 (online)

Abstract

Objective: It has become very important to avoid homologous blood transfusions in today's cardiac surgery. We performed a retrospective analysis to find out preoperative factors to predict the risk for transfusion of red-cell concentrate in cardiac surgery. Methods: This study included 400 consecutive patients undergoing coronary artery bypass grafting. We also included emergency (4 %) and re-operations (8 %). We tried to find out predictive factors for the need of transfusion of red-cell concentrate on the base of logistic regression coefficient and the odds ratio. We looked at the following factors as predictors of transfusion risk: left ventricular ejection fraction < 0.35, age over 70 years, preoperative hemoglobin < 11 g/dl, insulin-dependent diabetes (IDDM), emergency operation, female sex, impaired renal function (creatinine > 1.6 mg/dl), and re-operation. Results: In our group, 132 (33 %) patients received transfusion during hospitalization, while 268 (67 %) did not. On average, 2.2 ± 0.68 units of red-cell concentrate were transfused per patient. In addition, we found a predictive value for transfusion for the following parameters: age > 70 years, preoperative hemoglobin < 11 g/dl, re-operation and ejection fraction < 0.35. We could not find any significantly increased blood transfusion risk in female cases, insulin dependent diabetes mellitus, or impaired renal function. Conclusions: We could show that there is normally no need for blood transfusion in ⅔ of the patients in cardiac surgery according to this study's results. Furthermore, it was obvious that some patient variables can be used predict the risk for perioperative transfusion. Based on these results, the prophylactic administration of aprotinin or the use of a cell saver could be useful in se-lected patients.

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J. Litmathe

Department of Thoracic- and Cardiovascular Surgery, Heinrich-Heine-University

Moorenstraße 5

40225 Düsseldorf

Germany