Platelet transfusions are not associated with increased morbidity or mortality in cardiac surgery.
OBJECTIVE
To determine the independent relationship between leukoreduced platelet transfusions and adverse events in cardiac surgery.


METHODS
In this observational study, detailed baseline and perioperative data were prospectively collected on consecutive patients who underwent cardiac surgery at a single institution from 1999 to 2004. The independent associations of platelet transfusion with clinical outcomes (low output syndrome, myocardial infarction, stroke, renal failure, sepsis, and death) were determined by multivariable logistic regression analysis and propensity score case-control analysis.


RESULTS
Of the 11,459 patients analyzed, 2,174 (19%) received (leukoreduced) platelets - 1,408 received 5 U, 471 received 10 U, 140 received 15 U, and 155 received 20 or more units. Although all measured adverse event rates were higher in those who received platelets, in neither the logistic regression analyses nor the propensity score analyses was there any association between platelet transfusion and any of the adverse events.


CONCLUSIONS
Transfusion of leukoreduced platelets in cardiac surgery is not associated with adverse clinical outcomes when adjustments are made for important confounders.
Karkouti
Keyvan
K
Department of Anesthesia, University Health Network, University of Toronto, Toronto, Ontario, Canada. keyvan.karkouti@uhn.on.ca
Wijeysundera
Duminda N
DN
Yau
Terrence M
TM
Callum
Jeannie L
JL
Meineri
Massimiliano
M
Wasowicz
Marcin
M
McCluskey
Stuart A
SA
Beattie
W Scott
WS
D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects / Q000401:mortality* / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012189:Retrospective Studies