A multivariate analysis to assess the effect of packed red cell transfusion and the unit age of transfused red cells on postoperative complications in patients undergoing cardiac surgeries.
BACKGROUND
Transfusion of blood components and age of transfused packed red cells (PRCs) are independent risk factors for morbidity and mortality in cardiac surgeries.


METHODS
We retrospectively examined data of patients undergoing cardiac surgery at our institute from January 1, 2012 to September 30, 2012. Details of transfusion (autologous and allogenic), postoperative length of stay (PLOS), postoperative complications were recorded along with other relevant details. The analysis was done in two stages, in the first both transfused and nontransfused individuals and in the second only transfused individuals were considered. Age of transfused red cells as a cause of morbidity was analyzed only in the second stage.


RESULTS
Of the 762 patients included in the study, 613 (80.4%) were males and 149 (19.6%) were females. Multivariate analysis revealed that factors like the number and age of transfused PRCs and age of the patient had significant bearing upon the morbidity. Morbidity was significantly higher in the patients transfused with allogenic PRCs when compared with the patients not receiving any transfusion irrespective of the age of transfused PRCs. Transfusion of PRC of over 21 days was associated with higher postoperative complications, but not with in-hospital mortality.


CONCLUSIONS
In patients undergoing cardiac surgery, allogenic blood transfusion increases morbidity. The age of PRCs transfused has a significant bearing on morbidity, but not on in-hospital mortality. Blood transfusion services will therefore have to weigh the risks and benefits of providing blood older than 21 days in cardiac surgeries.
Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi, India.
Raj Nath
RN
Makroo
Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi, India.
Vikas
V
Hegde
Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi, India.
Aakanksha
A
Bhatia
Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi, India.
Mohit
M
Chowdhry
Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi, India.
Bhavna
B
Arora
Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi, India.
N L
NL
Rosamma
Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi, India.
Uday Kumar
UK
Thakur
Age of the packed red cell units; autologous transfusion; cardiac surgery; number of packed red cell units