Preoperative anemia and female gender as risk factors for transfusion in
patients undergoing coronary artery bypass grafting with a restrictive
transfusion strategy
Abstract
Background: Red blood cell (RBC) transfusion increases morbidity and
mortality after cardiac surgery. Despite the use of patient blood
management methods, blood transfusions may still be needed in cardiac
surgery. This study aims to determine the risk factors for blood
transfusions in isolated coronary bypass graft surgery with the use of a
restrictive transfusion strategy along with individualized patient blood
management. Methods: A total of 198 consecutive patients (28 females,
170 males; age range 38–87) who underwent isolated CABG surgery in
single private hospital using a restrictive transfusion strategy between
April 2015 and October 2020 were included in the study. Patients were
divided into two groups: with RBC transfusion and without RBC
transfusion. Preoperative, intraoperative, and postoperative values were
compared between groups. The risk factors for transfusion and
transfusion probability were analyzed. Results: Preoperative hematocrit
level and female gender (OR: 0.752; 95% CI 0.639–0.884; p = 0.001; OR:
7.874; 95% CI 1.678–36.950; p = 0.009, respectively) were the
statistically significant independent risk factors for red blood cell
transfusion. In female patients, the RBC transfusion probability was
61.08% when the preoperative hematocrit was 30%. The intensive care
unit and hospital stay were longer in the blood transfusion group.
Conclusions: The risk factors for RBC transfusion were preoperative
anemia and female gender in isolated CABG surgery with restrictive blood
transfusion strategies. Keywords: anemia, blood transfusion, coronary
artery bypass, patient blood management, restrictive blood transfusion