Storage age of transfused platelets and outcomes after cardiac surgery.
BACKGROUND
The relationship between duration of platelet (PLT) storage, currently limited to 5days, and surgical outcomes has not been established. We tested the hypothesis that PLT storage age was associated with adverse outcomes.


METHODS
A retrospective cohort of aortocoronary bypass (CABG) surgery patients from January 1996 to January 2005 receiving one or more PLT transfusions was selected for study. The composite primary ("short-term") outcome was 30-day mortality or prolonged hospital stay. Secondary outcomes included complications and survival to annual follow-up. Multivariable logistic regression models and Cox proportional hazards regression analysis evaluated the association between PLT storage age and outcomes, expressed as an odds ratio (OR) or hazard ratio with 95% confidence intervals (CIs), respectively.


RESULTS
PLT transfusion was administered to 3272 of 10,275 CABG patients and 2578 received units of known storage age, which ranged between 2 and 5days (median, 4days; 25th percentile, 3days; 75th percentile, 5 days). The mortality rate for the 1637 patients receiving a single plateletpheresis transfusion was 3.8%, while 21.6% experienced a prolonged hospital stay or death. After adjusting for the number of PLT and red blood cell (RBC) units transfused, RBC storage age, and preoperative mortality risk, there was no association between PLT storage age and short-term outcome (OR, 1.01; 95% CI, 0.90-1.14), survival (hazard ratio [HR], 1.04; 95% CI, 0.96-1.13), or postoperative infections.


CONCLUSIONS
PLT storage age was not associated with adverse short-term outcomes, decreased long-term survival, or infections after cardiac surgery.
Welsby
Ian J
IJ
Department of Anesthesiology, Duke University Medical Center, and the Duke Clinical Research Institute, Durham, North Carolina 27710, USA. welsb001@mc.duke.edu
Lockhart
Evelyn
E
Phillips-Bute
Barbara
B
Campbell
Mary Lee
ML
Mathew
Joseph P
JP
Newman
Mark F
MF
Peterson
Eric
E
Milano
Carmelo A
CA
D000017:ABO Blood-Group System; D000368:Aged; D001793:Blood Preservation / Q000009:adverse effects* / Q000379:methods*; D001803:Blood Transfusion / Q000401:mortality; D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017713:Platelet Transfusion / Q000009:adverse effects* / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D000017:ABO Blood-Group System