title: The effect of multiple blood conservation techniques on donor blood exposure in adult coronary and valve surgery performed with a membrane oxygenator: a multivariate analysis on 1310 patients.
abstract: The object of the study was to retrospectively evaluate protective and risk factors for receiving donor blood products and red cell transfusions after coronary and valve surgery performed with a hollow-fiber oxygenator and with multiple blood-saving techniques. During the period of January 1991 to June 1993, 1310 patients underwent primary coronary and valve surgery using a hollow-fiber oxygenator at our institution; the mean age of this population was 61 +/- 10 years; 977 patients were men (74.6%). Of these patients, 73.5% (963/1310) underwent coronary, 21.5% (281/1310) valve, and 5% (66/1310) combined surgery. Two hundred seventy-six (21.1%) needed donor blood product transfusions, while 153 (11.7%) patients underwent red cell transfusions. Significant risk factors for homologous blood product exposure after multivariate logistic regression analysis were, in order of importance: (1) postoperative blood loss (O.R. = 1.0009 per mL, p = 0.0000); (2) cardiopulmonary bypass (CPB) time (O.R. = 1.008 per min, p = 0.0001); (3) age at intervention (O.R. = 1.031 per calendar year, p = 0.0026); and (4) reoperation for bleeding (O.R. = 1.71, p = 0.0078). Protective factors were: (1) male gender (O.R. = 0.56, p = 0.0000); (2) preoperative withdrawal of autologous blood (O.R. = 0.66, p = 0.0018); and (3) a preoperative hematocrit greater than 34% (O.R. = 0.76, p = 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Cardiac Surgery-University of Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Parolari
authors.forename: C
authors.initials: C
authors.lastname: Antona
authors.forename: P
authors.initials: P
authors.lastname: Rona
authors.forename: P
authors.initials: P
authors.lastname: Gerometta
authors.forename: F
authors.initials: F
authors.lastname: Huang
authors.forename: F
authors.initials: F
authors.lastname: Alamanni
authors.forename: V
authors.initials: V
authors.lastname: Arena
authors.forename: P
authors.initials: P
authors.lastname: Biglioli
mesh_terms: D000367:Age Factors; D016913:Blood Component Transfusion; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D002315:Cardiopulmonary Bypass; D003331:Coronary Vessels / Q000601:surgery*; D017707:Erythrocyte Transfusion; D005260:Female; D006351:Heart Valves / Q000601:surgery*; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010107:Oxygenators, Membrane; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors