Blood transfusion in cardiac surgery is a risk factor for increased hospital length of stay in adult patients

Journal of Cardiothoracic Surgery

Ludhmila A Hajjar²  Jean-Louis Vincent¹  Jose Otavio Costa Auler²  Elisângela Pinto Marinho de Almeida²  Carolina MPDC Silva²  Rosana E Nakamura²  Eduardo A Osawa²  Julia T Fukushima²  Juliano P Almeida²  Filomena RBG Galas² 

[1] Department of Intensive Care, Erasme Hospital, Universita Libre de Bruxelles, Brussels, Belgium;Surgical Intensive Care Unit and Department of Anesthesiology, Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil

关键词: Length of stay;    Cardiac surgery;    Transfusion;   

Others  :  828376
DOI  :  10.1186/1749-8090-8-54

 received in 2012-12-06, accepted in 2013-03-04,  发布年份 2013

【 摘 要 】

Background

Allogeneic red blood cell (RBC) transfusion has been proposed as a negative indicator of quality in cardiac surgery. Hospital length of stay (LOS) may be a surrogate of poor outcome in transfused patients.

Methods

Data from 502 patients included in Transfusion Requirements After Cardiac Surgery (TRACS) study were analyzed to assess the relationship between RBC transfusion and hospital LOS in patients undergoing cardiac surgery and enrolled in the TRACS study.

Results

According to the status of RBC transfusion, patients were categorized into the following three groups: 1) 199 patients (40%) who did not receive RBC, 2) 241 patients (48%) who received 3 RBC units or fewer (low transfusion requirement group), and 3) 62 patients (12%) who received more than 3 RBC units (high transfusion requirement group). In a multivariable Cox proportional hazards model, the following factors were predictive of a prolonged hospital length of stay: age higher than 65 years, EuroSCORE, valvular surgery, combined procedure, LVEF lower than 40% and RBC transfusion of > 3 units.

Conclusion

RBC transfusion is an independent risk factor for increased LOS in patients undergoing cardiac surgery. This finding highlights the adequacy of a restrictive transfusion therapy in patients undergoing cardiac surgery.

Trial registration

Clinicaltrials.gov identifier: http://NCT01021631 webcite.

【 授权许可】

   
2013 Galas et al.; licensee BioMed Central Ltd.

【 图 表 】

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