title: Relationships among haemoglobin level, packed red cell transfusion and clinical outcomes in patients after cardiac surgery.
abstract: OBJECTIVE
  To identify associations among haemoglobin (Hb) concentrations, blood transfusions, and clinical outcomes in patients after cardiac surgery, especially in those who undergo valve replacement or bypass surgery.
  
  
  METHODS
  Prospective observational trial.
  
  
  METHODS
  Surgical intensive care unit in a tertiary-level university hospital.
  
  
  METHODS
  1216 Consecutive patients.
  
  
  METHODS
  Haemoglobin at admission and 6, 12, 24, and 48 h later, and then, every 24 h while patients remained in the intensive care unit (ICU); number of transfusions and clinical events.
  
  
  RESULTS
  Patients were divided into quartiles according to minimal haemoglobin, the first and second of which (Hb <8.10 and <8.91 g/dL, respectively) differed significantly (P < 0.001) from the other two quartiles in terms of more organ failure, longer ICU stay, and higher mortality. We found associations between being transfused >or=4 packed red cells (PRCs) and a worse clinical outcome and higher mortality. The associated mortality rate was higher for patients who underwent bypass surgery when they had Hb <or=8.9 g/dL and for those who underwent valve replacement when they had Hb >8.9 g/dL and were transfused >or=4 PRCs.
  
  
  CONCLUSIONS
  Low haemoglobin concentrations and transfusions in patients undergoing cardiac surgery are associated with increased morbidity and mortality. Also, anemia and transfusions are associated with poor outcome. Therefore, intra- and postoperative bleeding seem to be a risk factor in patients undergoing cardiac surgery.
authors: Department of Intensive Care, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, 08907 Barcelona, Spain. 36685eoj@comb.cat
authors: Eva
authors: E
authors: Oliver
authors: Maria L
authors: ML
authors: Carrio
authors: David
authors: D
authors: Rodríguez-Castro
authors: Casimiro
authors: C
authors: Javierre
authors: Elisabet
authors: E
authors: Farrero
authors: Herminia
authors: H
authors: Torrado
authors: Eduard
authors: E
authors: Castells
authors: Josep L
authors: JL
authors: Ventura
mesh_terms: D000368:Aged; D003422:Critical Care; D017707:Erythrocyte Transfusion; D004912:Erythrocytes; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies
chemical_list: D006454:Hemoglobins