title: Association between red blood cell storage duration and clinical outcome in patients undergoing off-pump coronary artery bypass surgery: a retrospective study.
abstract: BACKGROUND
  Prolonged storage of red blood cells (RBCs) leads to fundamental changes in both the RBCs and the storage media. We retrospectively evaluated the relationship between the RBC age and in-hospital and long-term postoperative outcomes in patients undergoing off-pump coronary artery bypass.
  
  
  METHODS
  The electronic medical records of 1,072 OPCAB patients were reviewed and information on the transfused RBCs and clinical data were collected. The effects of RBCs age (mean age, oldest age of transfused RBCs, any RBCs older than 14 days) on various in-hospital postoperative complications and long-term major adverse cardiovascular and cerebral events over a mean follow-up of 31 months were investigated. Correlations between RBCs age and duration of intubation, intensive care unit, or hospital stay, and base excess at the first postoperative morning were also analyzed.
  
  
  RESULTS
  After adjusting for confounders, there was no relationship between the RBCs age and in-hospital and long-term clinical outcomes except for postoperative wound complications. A significant linear trend was observed between the oldest age quartiles of transfused RBCs and the postoperative wound complications (quartile 1 vs. 2, 3 and 4: OR, 8.92, 12.01 and 13.79, respectively; P for trend = 0.009). The oldest transfused RBCs showed significant relationships with a first postoperative day negative base excess (P = 0.021), postoperative wound complications (P = 0.001), and length of hospital stay (P = 0.008).
  
  
  CONCLUSIONS
  In patients undergoing off-pump coronary artery bypass, the oldest age of transfused RBCs were associated with a postoperative negative base excess, increased wound complications, and a longer hospital stay, but not with the other in-hospital or long-term outcomes.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea ; Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jeong Jin
authors.initials: JJ
authors.lastname: Min
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jun-Yeol
authors.initials: JY
authors.lastname: Bae
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Tae Kyong
authors.initials: TK
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Deok Man
authors.initials: DM
authors.lastname: Hong
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Ho Young
authors.initials: HY
authors.lastname: Hwang
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Ki-Bong
authors.initials: KB
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Kyou-Sup
authors.initials: KS
authors.lastname: Han
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Yunseok
authors.initials: Y
authors.lastname: Jeon
mesh_terms: D000368:Aged; D001663:Bilirubin / Q000097:blood; D001793:Blood Preservation / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods*; D003422:Critical Care; D023381:Endpoint Determination; D017707:Erythrocyte Transfusion / Q000009:adverse effects* / Q000379:methods*; D004912:Erythrocytes / Q000502:physiology*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D001663:Bilirubin
keywords: Cardiac surgery; Old stored RBC; Postoperative outcome; RBC storage age; Wound complication