Authors: Frouke T R Voorhuis Jan M Dieleman Karen M K de Vooght Diederik van Dijk Lex A van Herwerden Linda M Peelen Wilton A van Klei
Publish Date: 2013/07/07
Volume: 92, Issue: 12, Pages: 1701-1706
Abstract
Stored red blood cells undergo progressive structural and functional changes over time Recently concerns have been raised about the transfusion of older red blood cell RBC concentrates after cardiac surgery The objective of the study was to test the hypothesis that longer storage time of RBCs increases the risk of adverse outcome after cardiac surgery This is a retrospective cohort study which includes patients who underwent coronary artery bypass surgery and/or valve surgery All patients were operated in the period from September 2006 to December 2010 and received 1 to 6 units of RBCs intraoperative or after surgery Patients were divided into two groups according to the storage time of the RBCs The “younger” group comprised patients who received RBCs ≤14 days old n = 111 and the “any older” group comprised patients who received RBCs 14 days old n = 710 Using univariable and multivariable regression analysis we examined the effect of storage time on the primary composite endpoint of death myocardial infarction and stroke major adverse cardiovascular events Secondary outcomes were prolonged ICU and hospital stay Data of 821 patients who received a total of 2004 RBCs were analyzed The median storage time for the younger group was 13 ± 2 days the median storage time for the “any older” group was 21 ± 5 days The incidence of the primary outcome was 86 in the “any older” group and 45 in the younger group adjusted odds ratio OR 168 95 confidence interval CI 065–434 Prolonged ICU stay was 123 in the “any older” group and 63 in the younger group adjusted OR 158 95 CI 069–366 In patients undergoing cardiac surgery transfusion of RBCs stored for more than 2 weeks was not associated with adverse outcomes
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