Cardiothoracic & vascular anesthesia
Impact of Preoperative Hematocrit, Body Mass Index, and Red Cell Mass on Allogeneic Blood Product Usage in Adult Cardiac Surgical Patients: Report From a Statewide Quality Initiative
Authors' conclusion
Transfusion probability modeling based on calculated RBC mass eliminated sex differences in transfusion risk based on preoperative hematocrit, and may better delineate which patients may benefit from more rigorous perioperative blood conservation strategy.
Study context
- Population
- Adults undergoing CABG ± valve replacement/repair, Maryland Cardiac Surgery Quality Initiative database, 2011–2019
- Participants
- 26,499 adults
- Exposure
- Body mass index (BMI) categories (<25, 25 to <30, ≥30 kg/m²); preoperative hematocrit and red blood cell (RBC) mass as predictors of allogeneic transfusion
- Outcome
- Allogeneic transfusion
Methodological detailsmulticentre, statewide quality initiative database, multivariable logistic regression
- Multicentre
- Statewide quality initiative database
- Multivariable logistic regression
Main finding
As reported in the abstract
Allogeneic transfusion (adjusted)
Odds ratio (95% CI)
BMI <25 vs BMI ≥30adjusted
1.26(1.08–1.39)
Per 1% increase in preoperative hematocrittransfusion decreased by 9%
0.91(0.90–0.92)
Per 500 mL increase in RBC mass43% reduction of transfusion
0.57(0.55–0.58)
Observational data: associations, not effects.
Further findings
Prevalence of preoperative anemia and any transfusion (entire cohort)
- Preoperative anemia
- 55.4%
- Any transfusion
- 49.3%
BMI and RBC mass by sex and age
- Females and older patients had lower BMI and RBC mass
Postoperative RBC and cryoprecipitate transfusion
- More frequent in the lower BMI group
Original publication
Impact of Preoperative Hematocrit, Body Mass Index, and Red Cell Mass on Allogeneic Blood Product Usage in Adult Cardiac Surgical Patients: Report From a Statewide Quality Initiative. J Cardiothorac Vasc Anesth. Published 5 April 2022. doi:10.
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