Cardiothoracic & vascular anesthesia
Association of Intraoperative Red Blood Cell Transfusions With Venous Thromboembolism and Adverse Outcomes After Cardiac Surgery
Authors' conclusion
Intraoperative PRBC transfusion was associated with HA-VTE and adverse outcomes after isolated CABG surgery.
Study context
- Population
- Patients with isolated coronary artery bypass grafting (CABG), January 1, 2015, to December 31, 2019
- Participants
- 751,893 patients
- Exposure
- Intraoperative packed red blood cell (PRBC) transfusion of 1, 2, 3 and ≥4 units vs no transfusion
- Outcome
- Hospital-acquired venous thromboembolic (HA-VTE) complications
Methodological detailspropensity score-weighted regression analysis, multi-institutional national registry
- Propensity score-weighted regression analysis
- Multi-institutional national registry
Main finding
As reported in the abstract
HA-VTE
Each group vs no PRBCOdds ratio (CI)
1 unit
1.27(1.22–1.32)
2 units
1.21(1.16–1.26)
3 units
1.93(1.85–2.00)
≥4 units
1.82(1.75–1.89)
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | |
|---|---|---|
| DVT1 unit vs No PRBC | 1.39 (1.33–1.46) | |
| DVT2 units vs No PRBC | 1.38 (1.32–1.44) | |
| DVT3 units vs No PRBC | 2.18 (2.09–2.28) | |
| DVT≥4 units vs No PRBC | 1.82 (1.74–1.91) | |
| Operative mortality1 unit vs No PRBC | 1.11 (1.08–1.14) | |
| Operative mortality2 units vs No PRBC | 1.16 (1.13–1.19) | |
| Operative mortality3 units vs No PRBC | 1.29 (1.26–1.32) | |
| Operative mortality≥4 units vs No PRBC | 1.47 (1.43–1.50) | |
| Readmission · 30 days1 unit vs No PRBC | 1.05 (1.04–1.06) | |
| Readmission · 30 days2 units vs No PRBC | 1.16 (1.13–1.19) | |
| Readmission · 30 days3 units vs No PRBC | 1.29 (1.26–1.32) | |
| Readmission · 30 days≥4 units vs No PRBC | 1.47 (1.43–1.50) | |
| Pulmonary venous thromboembolism1 unit vs No PRBC | 0.98 (0.91–1.06) | |
| Pulmonary venous thromboembolism2 units vs No PRBC | 0.75 (0.68–0.81) | |
| Pulmonary venous thromboembolism3 units vs No PRBC | 1.19 (1.09–1.29) | |
| Pulmonary venous thromboembolism≥4 units vs No PRBC | 1.35 (1.25–1.48) | |
| 0.512Odds ratio (log scale) |
| Outcome | Mean difference (days) (CI) | |
|---|---|---|
| Postoperative LOS1 unit vs No PRBC | 0.23 (0.19–0.27) | |
| Postoperative LOS2 units vs No PRBC | 0.34 (0.30–0.39) | |
| Postoperative LOS3 units vs No PRBC | 0.69 (0.64–0.74) | |
| Postoperative LOS≥4 units vs No PRBC | 0.77 (0.72–0.820) | |
| −0.500.51Difference, days (linear scale) |
- Pulmonary venous thromboembolism: lower for 1 or 2 units; significantly elevated for 3 and ≥4 units
Original publication
Association of Intraoperative Red Blood Cell Transfusions With Venous Thromboembolism and Adverse Outcomes After Cardiac Surgery. Ann Surg. Published 19 October 2022. doi:10.
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