Affiliations 

  • 1 National Blood Centre, Kuala Lumpur, Malaysia
  • 2 Laboratory and Blood Services Department, National Heart Institute, Kuala Lumpur, Malaysia
  • 3 Advanced Medical and Dental Institute, Universiti Sains Malaysia, Pulau Pinang, Malaysia
  • 4 Department of Anaesthesiology, National Heart Institute, Kuala Lumpur, Malaysia
  • 5 Community and Family Case Studies, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
Asian J Transfus Sci, 2017 Jul-Dec;11(2):95-101.
PMID: 28970674 DOI: 10.4103/ajts.AJTS_51_16

Abstract

CONTEXT: Coronary artery bypass graft (CABG) operation is associated with high frequency of allogeneic blood transfusion due to the acquired hemostatic challenges in patients undergoing CABG. However, allogeneic blood transfusion carries risks of infection, adverse reaction, and mortality as well as prolonged hospital stay and increased hospital cost. It is important to identify patients who require blood transfusion to mitigate their risk factors and reduce the chance of exposure to allogeneic blood.

AIMS: This study was conducted to evaluate factors that influence the decision to transfuse red cell in first-time elective CABG patients.

SETTINGS AND DESIGN: This was a cross-sectional study based on a retrospective record review. The study was done in the National Heart Institute.

MATERIALS AND METHODS: All patients who underwent first-time elective CABG were included in this study. Variables analyzed include age, gender, body weight, preoperative hemoglobin (Hb) level, patients' comorbidities, and other clinical parameters.

STATISTICAL ANALYSIS USED: Data were analyzed using SPSS software version 20.

RESULTS: A total of 463 patients underwent first-time elective CABG during the period of the study. Three hundred and eighty-six (83.4%) patients received red cell transfusion. From multiple logistic regression analysis, only age (odds ratio [OR] = 1.040, 95% confidence interval [CI]: 1.003, 1.077, P = 0.032), body weight (OR = 0.951, 95% CI: 0.928, 0.974, P < 0.001), Hb level (OR = 0.500, 95% CI: 0.387, 0.644, P < 0.001), and cardiopulmonary bypass time (OR = 1.013, 95% CI: 1.004, 1.023, P < 0.001) were the significant independent predictors of red cell transfusion.

CONCLUSIONS: By stratifying patients according to their risk factor for red cell transfusion, the high-risk patients could be recognized and should be enrolled into effective patient blood management program to minimize their risk of exposure to allogeneic blood transfusion.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.