title: The Clinical Implication of Blood Product Transfusion on Morbidity and Mortality of Ruptured Abdominal Aortic Aneurysm.
abstract: BACKGROUND
  Transfusion of blood products occurs frequently in ruptured abdominal aortic aneurysm surgery (rAAA). The aim of this study is to establish the impact of packed red blood cell (PRBC), fresh frozen plasma (FFP), and platelet (PLT) transfusion on the 30-day mortality and morbidity (thrombotic versus non thrombotic complications) of rAAAs.
  
  
  METHODS
  A retrospective study of 90 consecutive rAAAs from November 2007 to June 2015 was conducted. Multivariable regression models were produced to determine blood products associated with 30-day morbidity and mortality post-rAAA.
  
  
  RESULTS
  The overall mortality was 14.6%. At multivariable analyses, transfusion with FFP (>3 units) was independently associated with an increased risk of mortality (odds ratio [OR]: 11.27, 95% confidence interval [CI]: 1.13-96.72, P = .027). The overall morbidity was 26.8%, and subgroup analysis (thrombotic vs nonthrombotic complications) demonstrated transfusion of PLTs (>1 pool) to be independently associated with thrombotic events (OR: 4.3, 95% CI: 1.37-13.6, P = .012). Thrombotic events were responsible for 50% (n = 11 of 22) of all morbidities and mortalities (n = 6 of 12).
  
  
  CONCLUSIONS
  Transfusion of FFP and PLTs may be associated with an increased risk of postoperative morbidity and mortality. The use of these blood components should be considered in the context of the patient's clinical and laboratory data as opposed to a fixed ratio to PRBCs. This may result in the reduction in thrombotic complications emerging in rAAA cohort.
authors.affiliation: 1 Department of Vascular & Endovascular Surgery, Broomfield Hospital, Mid Essex Hospitals Services NHS Trust, Essex, Broomfield, United Kingdom.|2 Anglia Ruskin University, Cambridge, United Kingdom.
authors.forename: Ali
authors.initials: A
authors.lastname: Kordzadeh
authors.affiliation: 3 London North West Hospitals Trust, Imperial College London, London, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Askari
authors.affiliation: 2 Anglia Ruskin University, Cambridge, United Kingdom.
authors.forename: Ali D
authors.initials: AD
authors.lastname: Parsa
authors.affiliation: 1 Department of Vascular & Endovascular Surgery, Broomfield Hospital, Mid Essex Hospitals Services NHS Trust, Essex, Broomfield, United Kingdom.
authors.forename: Tom
authors.initials: T
authors.lastname: Browne
authors.affiliation: 1 Department of Vascular & Endovascular Surgery, Broomfield Hospital, Mid Essex Hospitals Services NHS Trust, Essex, Broomfield, United Kingdom.
authors.forename: Yiannis P
authors.initials: YP
authors.lastname: Panayiotopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D001019:Aortic Rupture / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D016913:Blood Component Transfusion / Q000009:adverse effects; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009026:Mortality; D010949:Plasma; D017713:Platelet Transfusion / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology; D055815:Young Adult
keywords: blood component transfusion; blood transfusion; morbidity; mortality; platelet; ruptured abdominal aortic aneurysm (rAAA); thrombosis: fresh frozen plasma