Effects of Blood Transfusion on Hospital Mortality During Coronary Artery Bypass Grafting

Abstract

Introduction: Blood transfusion in cardiac surgery patients may cause mortality although it is a life saver under specific conditions. Recently published papers advocate that reduction in blood products due to transfusion caused early and long-term mortality. In cardiac surgery patients, it is unclear as to which period of perioperative transfusion is more hazardous. Here, we studied perioperative mortality according to transfusion. Patients and Methods: A total of 137 patients (29 female) were enrolled between April 2008 and February 2013. Target hematocrit levels during cardiopulmonary bypass were (HTC) 20%-25%, and post cardiopulmonary bypass target hematocrit levels were 25%-30%. During postoperative follow-up, transfusion was performed if patients had symptoms due to anemia. Otherwise, the lowest postoperative target hematocrit level was 26%. Fresh frozen plasma was used either for volume expansion or for coagulopathy correction. For anemia correction, only erythrocyte suspension was used. Results: A total of 137 patients participated in this study. Of those 137, 108 were male (78.8%). The mean age of the patients in the study group was 60.88 ± 9.84 (range, 36-82) years. Hospital mortality was observed in 28 (20.4%) patients. Intraoperative 2 or more transfusion of erythrocyte suspension has 81.65% specificity and 46.43% sensitivity to predicts mortality. Conclusion: Intraoperative transfusion during cardiopulmonary bypass negatively affects hospital mortality. Hence, necessary precautions should be taken to avoid transfusion.