Cardiothoracic & vascular anesthesia
Determining sex-specific preoperative haemoglobin levels associated with intraoperative red blood cell transfusion in cardiac surgery: a retrospective cohort study
Authors' conclusion
The World Health Organization female anaemia threshold of haemoglobin <120 g L-1 disproportionately disadvantages female cardiac surgery patients. A preoperative haemoglobin concentration ≥130 g L-1 in adult cardiac surgery patients would minimise their overall probability of intraoperative red blood cell transfusion to <15%.
Study context
- Population
- Adults ≥18 yr undergoing cardiac surgery with CPBanalysed
- Participants
- 4,384 vs 1,676
- Exposure
- Male vs Female
- Malen = 4,384
- Femalen = 1,676
- Outcome
- Intraoperative RBC transfusion
Methodological detailsmultivariable logistic regression
- Multivariable logistic regression
Main finding
As reported in the abstract
Preoperative haemoglobin required for 15% probability of intraoperative transfusion
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Odds of intraoperative RBC transfusion per 1 g L-1 increase in preoperative haemoglobinOdds decreased by 8.4% · multivariable logistic regression | 0.92 (0.91–0.92) | |
| 0.512Odds ratio (log scale) |
Other factors associated with intraoperative RBC transfusion
| OR (95% CI) | ||
|---|---|---|
| Cardiac surgery patients >45 yr oldBinarily stratified multivariable logistic regression | 1.84 (1.33–2.55) | |
| Surgery urgency <30 daysBinarily stratified multivariable logistic regression | 2.03 (1.66–2.48) | |
| Combined coronary artery bypass grafting and valve surgery, or other surgery typesBinarily stratified multivariable logistic regression | 2.24 (1.87–2.67) | |
| Female sexBinarily stratified multivariable logistic regression | 1.92 (1.62–2.28) | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Determining sex-specific preoperative haemoglobin levels associated with intraoperative red blood cell transfusion in cardiac surgery: a retrospective cohort study. Br J Anaesth. Published 29 August 2023. doi:10.
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