The effect of preoperative aspirin-free interval on red blood cell transfusion requirements in cardiac surgical patients.
OBJECTIVE
To compare red blood cell transfusion in first-time coronary artery surgery patients who stopped taking aspirin < or = 2 days, 3 to 7 days, or >7 days preoperatively.


METHODS
Observational study.


METHODS
University-affiliated teaching hospital.


METHODS
Adult patients (n = 797) undergoing first-time coronary artery surgery on cardiopulmonary bypass who were not receiving other anticoagulant or antiplatelet drugs before surgery.


METHODS
None.


RESULTS
Patients were divided into 4 groups based on days since last ingestion of aspirin. Blood products transfused in the groups were (aspirin < or =2 days) (n = 140) 2.2 +/- 4 U of red cell concentrate (RCC) (mean +/- SD), 1.4 +/- 3 U of fresh frozen plasma (FFP), and 2.7 +/- 6 U of platelets; (aspirin 3 to 5 days) (n = 255), 1.5 +/- 2 U of RCC, 0.8 +/- 2 U of FFP, and 1.6 +/- 4 U of platelets; (aspirin 6 to 7 days) (n = 215), 1.6 +/- 3 U of RCC, 0.9 +/- 3 U of FFP, and 1.5 +/- 3 U of platelets; and (aspirin >7 days) (n = 187), 1.3 +/- 2 U of RCC; 0.6 +/- 2 U of FFP, and 0.9 +/- 2 U of platelets.


CONCLUSIONS
Patients who stop taking aspirin < or =2 s preoperatively have increased allogenic red blood cell transfusion requirements perioperatively. Patients who stop taking aspirin 3 to 7 days preoperatively have little or no increased requirement for allogenic red blood cell transfusion.
Weightman
William M
WM
Departments of Anaesthesia and Cardiothoracic Surgery, Sir Charles Gairdner Hospital, and PathCentre, Nedlands, Western Australia.
Gibbs
Neville M
NM
Weidmann
Crispin R
CR
Newman
Mark A J
MA
Grey
Diane E
DE
Sheminant
Matthew R
MR
Erber
Wendy N
WN
D001241:Aspirin / Q000008:administration & dosage*; D016063:Blood Loss, Surgical; D001026:Coronary Artery Bypass; D017707:Erythrocyte Transfusion; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D010976:Platelet Count; D017713:Platelet Transfusion; D011300:Preoperative Care; D012307:Risk Factors
D006454:Hemoglobins; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin