Perioperative Red Blood Cell Transfusion Is Associated With Adverse Cardiovascular Outcomes in Heart Valve Surgery
Authors' conclusion
In the analysis of the national cohort, perioperative RBC transfusion during heart valve surgery was associated with adverse cardiovascular outcomes correlated with the volume of RBC transfusion.
Study context
- Population
- Patients undergoing heart valve surgery (aortic, mitral, tricuspid or complex valves), National Health Insurance Service database, 2003–201986.5% transfused
- Participants
- 58,299 patients
- Exposure
- Perioperative red blood cell (RBC) transfusion of 1, 2 or ≥3 units vs no transfusion
- Outcome
- Death, ischemic stroke, hemorrhagic stroke and admission for MI during follow-up
- Follow-up
- Median 5.53 years
Methodological detailsnational health insurance database, multivariable Cox proportional hazards model
- National health insurance database
- Multivariable Cox proportional hazards model
Main finding
As reported in the abstract
Long-term adverse events:
- Death
- Ischemic stroke
- Hemorrhagic stroke
- MI
Each group vs 0Adjusted hazard ratio (95% CI)
1death
1.53(1.41–1.66)
2death
1.97(1.81–2.14)
≥3death
3.03(2.79–3.29)
1ischemic stroke
1.27(1.16–1.39)
2ischemic stroke
1.31(1.19–1.44)
≥3ischemic stroke
1.51(1.38–1.66)
1hemorrhagic stroke
1.38(1.16–1.66)
2hemorrhagic stroke
1.71(1.43–2.05)
≥3hemorrhagic stroke
2.31(1.94–2.76)
1MI
1.35(1.13–1.62)
2MI
1.60(1.33–1.91)
≥3MI
1.99(1.66–2.38)
Observational data: associations, not effects.
Original publication
Perioperative Red Blood Cell Transfusion Is Associated With Adverse Cardiovascular Outcomes in Heart Valve Surgery. Anesth Analg. Published 1 November 2022. doi:10.
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