title: Impact on early and late mortality after blood transfusion in coronary artery bypass graft surgery.
abstract: OBJECTIVE
  To assess the 30-day and 1-year mortality associated to the red blood cell transfusion after coronary artery bypass grafting surgery. This procedure has been questioned by the international medical community, but it is still widely used in cardiac surgery. Therefore, it is needed more evidence of this medical practice in our country.
  
  
  METHODS
  We retrospectively analyzed 3,004 patients who underwent coronary artery bypass grafting surgery between June 2009 and July 2010. Patients were divided into two groups: non-transfused and transfused.
  
  
  RESULTS
  The transfused group totaled 1,888 (63%) and non-transfused 1,116 (37%). There were 129 deaths in 30 days, with 108 (84%) in the transfused group and 21 (16%) in the non-transfused (P<0.001). One year mortality totaled 249 distributed in 212 (85%) among transfused patients and 37 (15%) in non-transfused (P<0.001). The adjusted odds ratio for mortality in patients transfused was 2.00 (P=0.007) in 30 days and 2.31 (P=0.003) in 1 year. Even in low risk patients (age < 60 years and EuroSCORE < 2 points), and so with fewer comorbidities, both outcomes, 30 day and 1 year mortality were significantly higher in the transfused patients (7.0% vs. 0.0%, P< 0.001) and (10.0% vs. 0.0%, P< 0.001), respectively.
  
  
  CONCLUSIONS
  The perioperative red blood cell transfusions after coronary artery bypass grafting surgery increased significantly the 30-day and 1-year mortality, even after the adjustments for comorbidities and other factors. So, new therapeutic options and autologous blood management and conservation strategies should be encouraged to reduce blood products transfusions.
authors.affiliation: Portuguese Beneficent Hospital of São Paulo, São Paulo, SP, Brazil. antonioalceu@cardiol.br
authors.forename: Antonio Alceu dos
authors.initials: AA
authors.lastname: Santos
authors.forename: Alexandre Gonçalves
authors.initials: AG
authors.lastname: Sousa
authors.forename: Hugo Oliveira de Souza
authors.initials: HO
authors.lastname: Thomé
authors.forename: Roberta Longo
authors.initials: RL
authors.lastname: Machado
authors.forename: Raquel Ferrari
authors.initials: RF
authors.lastname: Piotto
mesh_terms: D000367:Age Factors; D000368:Aged; D001803:Blood Transfusion / Q000401:mortality*; D001938:Brazil; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality*; D004812:Epidemiologic Methods; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D065227:Transfusion Reaction