title: The Role of Blood Transfusion in the Development of Atrial Fibrillation after Coronary Artery Bypass Grafting.
abstract: ObjectivesAtrial fibrillation (AF) is the most common complication after coronary artery bypass grafting (CABG). It is associated with prolonged hospital stay and increased cost. The aim of this study is to investigate the relationship between transfusion of blood derivatives and occurrence of postoperative paroxysmal AF.Materials and MethodsFrom June 2012 to February 2014, 446 patients undergoing CABG with cardiopulmonary bypass (CPB) were prospectively evaluated for occurrence of postoperative AF. Patients and procedural variables were recorded and were associated with the development of new-onset AF with logistic regression analysis.ResultsAF developed in 111 patients (24.9%). Preoperative factors associated with the development of new-onset AF included age (p< 0.05), higher EuroSCORE II (p< 0.05), carotid disease (p= 0.01), peripheral vascular disease (p= 0.02), chronic obstructive pulmonary disease (p= 0.03), renal failure (p= 0.05), and cardiac failure (p= 0.01). Intraoperative and postoperative parameters included duration of CPB (p< 0.05), number of grafts (p= 0.009), intubation time (p= 0.001), occurrence of postoperative stroke (p= 0.01), transient ischemic attack (p= 0.02), need for prolonged ventilation (p= 0.002), development of respiratory tract infection (p= 0.02), need for noninvasive ventilation (p= 0.001), reintubation (p= 0.02), development of postoperative acute kidney injury (p= 0.002), and postoperative neurocognitive dysfunction (p= 0.002). The number of red blood cell (RBC) units transfused during surgery (p= 0.7) and the total number of RBC units transfused (p= 0.2) as well as units of fresh frozen plasma (p= 0. 7) and platelets units transfused in total (p= 0.3) were not found to increase the risk of postoperative AF.ConclusionIntraoperative and postoperative blood products transfusion in patients operated for CABG is not associated with increased risk of developing postoperative AF.
authors: Departement of CardiothoracicSurgery, General Hospital George Papanikolaou, Thessaloniki, Greece.
authors: Athanasia
authors: A
authors: Vlahou
authors: Departement of CardiothoracicSurgery, General Hospital George Papanikolaou, Thessaloniki, Greece.
authors: Konstantinos
authors: K
authors: Diplaris
authors: Departement of CardiothoracicSurgery, General Hospital George Papanikolaou, Thessaloniki, Greece.
authors: Fotini
authors: F
authors: Ampatzidou
authors: Departement of Cardiology, Interbalkan Medical Center, Thessaloniki, Greece.
authors: Lampos
authors: L
authors: Karagounnis
authors: Departement of CardiothoracicSurgery, General Hospital George Papanikolaou, Thessaloniki, Greece.
authors: George
authors: G
authors: Drossos
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D065227:Transfusion Reaction; D016896:Treatment Outcome