title: Gender is an essential determinant of blood transfusion in patients undergoing coronary artery bypass graft procedure.
abstract: OBJECTIVE
  To determine factors that account for gender difference in the need for blood transfusion in coronary artery bypass graft (CABG) patients.
  
  
  METHODS
  Retrospective study of consecutive patients.
  
  
  METHODS
  Anesthesiology department of a teaching hospital.
  
  
  METHODS
  253 CABG patients (163 males and 90 females).
  
  
  METHODS
  Packed red blood cells (PRBCs), platelets, and fresh frozen plasma (FFP) were transfused depending on the need of each patient.
  
  
  RESULTS
  For each patient, we recorded the gender, age, weight, height, body surface area (BSA), and duration of surgery. Hematocrit (Hct) levels prior to surgery, end of surgery, and at discharge from the hospital were recorded. PRBC administration and use of FFP and platelets were noted. Differences between the data for female and male patients were evaluated using Student's t-test, Chi-square test, and regression analysis. Approximately 60% female and only 20% male patients received PRBCs intraoperatively, whereas 78% females and only 43% males received PRBCs during their entire hospital stay. On average, females received 1.20 units of PRBCs intraoperatively and 2.38 units during the entire hospital stay, while the males received 0.31 units and 1.36 units for similar periods. Gender differences in PRBC transfusion persisted even when females and males were compared within the same subgroups for age, weight, duration of surgery, and preoperative Hct. PRBC units given intraoperatively had a significant correlation with age and preoperative Hct in females, but they had a significant correlation with age, preoperative Hct, and duration of surgery in males. PRBCs given during the entire hospital stay, however, had significant correlation with age, preoperative Hct, and duration of surgery in both females and males. Multiple logistic regression analysis showed that the probability of a patient receiving or not receiving PRBC transfusion is significantly influenced by age, preoperative PRBC mass, duration of surgery, and gender.
  
  
  CONCLUSIONS
  Gender is an independent essential determinant of blood transfusion in CABG patients, and it may interact with age, weight, preoperative Hct, duration of surgery, and other factors in determining the probability of transfusion.
authors.affiliation: Department of Anesthesiology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
authors.forename: K
authors.initials: K
authors.lastname: Shevde
authors.forename: M
authors.initials: M
authors.lastname: Pagala
authors.forename: A
authors.initials: A
authors.lastname: Kashikar
authors.forename: C
authors.initials: C
authors.lastname: Tyagaraj
authors.forename: N
authors.initials: N
authors.lastname: Shahbaz
authors.forename: M
authors.initials: M
authors.lastname: Iqbal
authors.forename: R
authors.initials: R
authors.lastname: Idupuganti
mesh_terms: D000367:Age Factors; D000368:Aged; D001803:Blood Transfusion; D001827:Body Height; D001830:Body Surface Area; D001835:Body Weight; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D017707:Erythrocyte Transfusion; D004911:Erythrocyte Volume; D005260:Female; D005500:Follow-Up Studies; D006400:Hematocrit; D006801:Humans; D007430:Intraoperative Care; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D010949:Plasma; D017713:Platelet Transfusion; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors