title: Revisiting blood transfusion and predictors of outcome in cardiac surgery patients: a concise perspective.
abstract: In the United States, cardiac surgery-related blood transfusion rates reached new highs in 2010, with 34% of patients receiving blood products. Patients undergoing both complex (coronary artery bypass grafting [CABG] plus valve repair or replacement) and non-complex (isolated CABG) cardiac surgeries are likely to have comorbidities such as anemia. Furthermore, the majority of patients undergoing isolated CABG have a history of myocardial infarction. These characteristics may increase the risk of complications and blood transfusion requirement. It becomes difficult to demonstrate the association between transfusions and mortality because of the fact that most patients undergoing cardiac surgery are also critically ill. Transfusion rates remain high despite the advances in perioperative blood conservation, such as the intraoperative use of cell saver in cardiac surgery. Some recent prospective studies have suggested that the use of blood products, even in low-risk patients, may adversely affect clinical outcomes. In light of this information, we reviewed the literature to assess the clinical outcomes in terms of 30-day and 1-year morbidity and mortality in transfused patients who underwent uncomplicated CABG surgery.
authors.affiliation: Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Arias-Morales
authors.affiliation: Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Nicoleta
authors.initials: N
authors.lastname: Stoicea
authors.affiliation: Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Alicia A
authors.initials: AA
authors.lastname: Gonzalez-Zacarias
authors.affiliation: College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Slawski
authors.affiliation: College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA.
authors.forename: Sujatha P
authors.initials: SP
authors.lastname: Bhandary
authors.affiliation: Second Department of Anesthesiology, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Theodosios
authors.initials: T
authors.lastname: Saranteas
authors.affiliation: Second Department of Anesthesiology, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Eva
authors.initials: E
authors.lastname: Kaminiotis
authors.affiliation: College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Papadimos
keywords: blood transfusion; cardiac surgery; cardiopulmonary bypass; length of stay; mortality