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Increased long-term mortality with plasma transfusion after coronary artery bypass surgery.

Bjursten, Henrik LU ; Dardashti, Alain LU ; Ederoth, Per LU ; Brondén, Björn LU and Algotsson, Lars LU (2013) In Intensive Care Medicine 39(3). p.437-444
Abstract
PURPOSE: Patients undergoing cardiac surgery often require transfusions of red blood cells, plasma and platelets. These components differ widely in both indications for use and composition. However, from a statistical point of view there is a significant colinearity between the components. This study explores the relation between the transfusion of different blood components and long-term mortality. METHODS: A retrospective single-centre study was performed including 5,261 coronary artery bypass grafting patients, excluding patients receiving more than eight units of red blood cells, those suffering early death (7 days) and emergency cases. Patients were followed up for a period of up to 7.5 years. A broad spectrum of potential risk... (More)
PURPOSE: Patients undergoing cardiac surgery often require transfusions of red blood cells, plasma and platelets. These components differ widely in both indications for use and composition. However, from a statistical point of view there is a significant colinearity between the components. This study explores the relation between the transfusion of different blood components and long-term mortality. METHODS: A retrospective single-centre study was performed including 5,261 coronary artery bypass grafting patients, excluding patients receiving more than eight units of red blood cells, those suffering early death (7 days) and emergency cases. Patients were followed up for a period of up to 7.5 years. A broad spectrum of potential risk factors was analysed using Cox proportional hazards survival regression. Non-significant risk factors were removed by step-wise elimination, and transfusion of red blood cells, plasma and platelets was forced to remain in the model. RESULTS: The transfusion of red blood cells was not associated with decreased long-term mortality (HR = 1.007, p = 0.775), whereas the transfusion of plasma was associated with decreased long-term survival (HR = 1.060, p < 0.001), and the transfusion of platelets was associated with increased long-term survival (HR = 0.817, p = 0.011). The risk associated with transfusion of plasma was mainly attributed to patients receiving large amounts of plasma. All hazard ratios are per unit of blood product transfused. CONCLUSIONS: No association was found between the transfusion of red blood cells and mortality during the study period. However, transfusion of plasma was associated with increased mortality while transfusion of platelets was associated with decreased mortality during the study period. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Intensive Care Medicine
volume
39
issue
3
pages
437 - 444
publisher
Springer
external identifiers
  • wos:000315333700013
  • pmid:23052960
  • scopus:84884212813
ISSN
0342-4642
DOI
10.1007/s00134-012-2723-9
language
English
LU publication?
yes
id
7cc37306-dfd6-4664-b3fe-fbdefeed4185 (old id 3160880)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23052960?dopt=Abstract
date added to LUP
2012-11-01 16:11:36
date last changed
2018-05-29 10:18:00
@article{7cc37306-dfd6-4664-b3fe-fbdefeed4185,
  abstract     = {PURPOSE: Patients undergoing cardiac surgery often require transfusions of red blood cells, plasma and platelets. These components differ widely in both indications for use and composition. However, from a statistical point of view there is a significant colinearity between the components. This study explores the relation between the transfusion of different blood components and long-term mortality. METHODS: A retrospective single-centre study was performed including 5,261 coronary artery bypass grafting patients, excluding patients receiving more than eight units of red blood cells, those suffering early death (7 days) and emergency cases. Patients were followed up for a period of up to 7.5 years. A broad spectrum of potential risk factors was analysed using Cox proportional hazards survival regression. Non-significant risk factors were removed by step-wise elimination, and transfusion of red blood cells, plasma and platelets was forced to remain in the model. RESULTS: The transfusion of red blood cells was not associated with decreased long-term mortality (HR = 1.007, p = 0.775), whereas the transfusion of plasma was associated with decreased long-term survival (HR = 1.060, p &lt; 0.001), and the transfusion of platelets was associated with increased long-term survival (HR = 0.817, p = 0.011). The risk associated with transfusion of plasma was mainly attributed to patients receiving large amounts of plasma. All hazard ratios are per unit of blood product transfused. CONCLUSIONS: No association was found between the transfusion of red blood cells and mortality during the study period. However, transfusion of plasma was associated with increased mortality while transfusion of platelets was associated with decreased mortality during the study period.},
  author       = {Bjursten, Henrik and Dardashti, Alain and Ederoth, Per and Brondén, Björn and Algotsson, Lars},
  issn         = {0342-4642},
  language     = {eng},
  number       = {3},
  pages        = {437--444},
  publisher    = {Springer},
  series       = {Intensive Care Medicine},
  title        = {Increased long-term mortality with plasma transfusion after coronary artery bypass surgery.},
  url          = {http://dx.doi.org/10.1007/s00134-012-2723-9},
  volume       = {39},
  year         = {2013},
}