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. 2014 Oct 21:14:95.
doi: 10.1186/1471-2253-14-95. eCollection 2014.

Association between red blood cell storage duration and clinical outcome in patients undergoing off-pump coronary artery bypass surgery: a retrospective study

Jeong Jin Min  1 , Jun-Yeol Bae  2 , Tae Kyong Kim  2 , Deok Man Hong  2 , Ho Young Hwang  3 , Ki-Bong Kim  3 , Kyou-Sup Han  4 , Yunseok Jeon  2
Affiliations

Association between red blood cell storage duration and clinical outcome in patients undergoing off-pump coronary artery bypass surgery: a retrospective study

Jeong Jin Min et al. BMC Anesthesiol. .

Abstract

Background: Prolonged storage of red blood cells (RBCs) leads to fundamental changes in both the RBCs and the storage media. We retrospectively evaluated the relationship between the RBC age and in-hospital and long-term postoperative outcomes in patients undergoing off-pump coronary artery bypass.

Methods: The electronic medical records of 1,072 OPCAB patients were reviewed and information on the transfused RBCs and clinical data were collected. The effects of RBCs age (mean age, oldest age of transfused RBCs, any RBCs older than 14 days) on various in-hospital postoperative complications and long-term major adverse cardiovascular and cerebral events over a mean follow-up of 31 months were investigated. Correlations between RBCs age and duration of intubation, intensive care unit, or hospital stay, and base excess at the first postoperative morning were also analyzed.

Results: After adjusting for confounders, there was no relationship between the RBCs age and in-hospital and long-term clinical outcomes except for postoperative wound complications. A significant linear trend was observed between the oldest age quartiles of transfused RBCs and the postoperative wound complications (quartile 1 vs. 2, 3 and 4: OR, 8.92, 12.01 and 13.79, respectively; P for trend = 0.009). The oldest transfused RBCs showed significant relationships with a first postoperative day negative base excess (P = 0.021), postoperative wound complications (P = 0.001), and length of hospital stay (P = 0.008).

Conclusions: In patients undergoing off-pump coronary artery bypass, the oldest age of transfused RBCs were associated with a postoperative negative base excess, increased wound complications, and a longer hospital stay, but not with the other in-hospital or long-term outcomes.

Keywords: Cardiac surgery; Old stored RBC; Postoperative outcome; RBC storage age; Wound complication.

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Figures

Figure 1
Figure 1
Storage age of all transfused RBCs. The figure shows the distribution of RBCs age and the number of transfusions for each RBCs age. RBC, red blood cell.
Figure 2
Figure 2
Transfusion amounts per patient and its relationship with the RBCs age. Bars represent the number of cases for each transfusion amounts. In each number of transfusions, squares (□) represent the average value of ‘oldest age of transfused RBCs’ and triangles (△) represent the average value of ‘mean age of transfused RBCs’. RBC, red blood cell.
See this image and copyright information in PMC

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Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2253/14/95/prepub

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