ATLANTA — Despite guidelines recommending against red blood cell transfusions in patients undergoing coronary artery bypass graft surgery, the practice remains fairly common and is often detrimental, a study shows.
Of 940 stable CABG patients from the Multicenter Study of Perioperative Ischemia Epidemiology II (EPI II), 20% received red blood cell transfusions, and these patients were significantly more likely than those who did not receive a transfusion to experience myocardial infarction (odds ratio 1.9), renal dysfunction (OR 3.4), renal failure requiring dialysis (OR 4.0), and/or harvest-site wound infection (OR 5.5), Dr. Jack Levin reported at the annual meeting of the American Society of Hematology.
Red blood cell transfusion was shown on multivariate analysis to be an independent predictor of composite morbidity outcome, cardiac morbidity, and harvest-site wound infection, said Dr. Levin of University of California, San Francisco. Transfusion also resulted in a longer hospital stay; 14.4 days for transfused patients, compared with 11.9 days for nontransfused patients.
Patients included only those from EPI II with a low to moderate risk profile, postoperative hemoglobin levels of at least 10 g/dL, minimal postoperative blood loss, and no evidence of a morbid event on the day of surgery. They were followed postoperatively for 24 hours to assess the transfusion, and until hospital discharge to assess multiorgan outcomes and resource use.