title: The impact of blood transfusion on morbidity and mortality after cardiac surgery.
abstract: OBJECTIVE
  To analyze the impact of blood transfusion on the incidence of clinical outcomes postoperatively (PO) from cardiac surgery.
  
  
  METHODS
  Retrospective cohort study. We analyzed 4028 patients undergoing coronary artery bypass grafting (CABG), valve (TV), or both, in Brazilian tertiary university hospital between 1996 and 2009. We compared the postoperative complications between patients with blood transfusion (n = 916) and non-blood transfusion (n = 3112). Univariate analysis was performed using the Student t test, and multivariate logistic regression bivariate (stepwise forward). Were considered significant variables with P <0.05.
  
  
  RESULTS
  Patients who received blood transfusions had more infectious episodes as mediastinitis (4.9% vs. 2.2%, P <0.001), respiratory infection (27.8% vs 17.1%, P <0.001) and sepsis (6.2% vs. 2.5%, P <0.001). There were more episodes of atrial fibrillation (AF) (27% vs. 20.4%, P <0.001), acute renal failure (ARF) (14.5% vs 7.3%, P <0.001) and stroke (4.8% vs. 2.6%, P = 0.001). The length of PO hospital stay was higher in transfused (13 ± 12.07 days vs. 9.72 ± 7.66 days, P <0.001). However, mortality didn't differ between groups (10.9% vs. 9.1%, P = 0.112). The transfusion was shown to be a risk factor for: respiratory infection (OR: 1.91, 95% CI 1.59-2.29, P <0.001), AF (OR: 1.35, 95% CI 1.13-1.61, P = 0.01), sepsis (OR: 2.08, 95% CI 1.4-3.07, P <0.001), mediastinitis (OR: 2.14, 95% CI: 1.43-3.21, P <0.001), stroke (OR: 1.63, 95% CI 1.1-2.41, P = 0.014) and ARF (OR 1.8, 95% CI: 1.39-2.33, P <0.001).
  
  
  CONCLUSIONS
  The blood transfusion is associated with increased risk of infectious events, episodes of AF, ARF and stroke, as well as the increased length of hospital stay but not mortality.
authors: Department of Cardiology, Catholic University of Rio Grande do Sul (PUCRS) Medical School, Porto Alegre, Brazil. camilacdorneles@yahoo.com.br
authors: Camila de Christo
authors: Cde C
authors: Dorneles
authors: Luiz Carlos
authors: LC
authors: Bodanese
authors: João Carlos Vieira da Costa
authors: JC
authors: Guaragna
authors: Fabrício Edler
authors: FE
authors: Macagnan
authors: Juliano Cé
authors: JC
authors: Coelho
authors: Anibal Pires
authors: AP
authors: Borges
authors: Marco Antonio
authors: MA
authors: Goldani
authors: João Batista
authors: JB
authors: Petracco
mesh_terms: D000368:Aged; D001803:Blood Transfusion / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D009204:Myocardial Revascularization / Q000009:adverse effects* / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D065227:Transfusion Reaction