Sandoughdaran Saleh, Sarzaeem Mahmood Reza, Bagheri Jamshid, Jebelli Mohammad, Mandegar Mohammad Hossein
Cardiac Surgery and Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Int Cardiovasc Res J. 2013 Mar;7(1):25-8. Epub 2013 Mar 15.
The aim of this retrospective study is to identify intraoperative patient's characteristics predicting the need for blood transfusion during CABG in our local cardiac surgical service.
This study included 1835 consecutive patients, 1311 males and 524 females with mean age 58.8±9.9 years, undergoing coronary artery bypass grafting. Risk factors detected by univariate study were entered in a multivariate logistic regression model of the relationship between preoperative variables and blood transfusion.
Blood transfusion was used in 435 patients (29.9%). Univariate analysis identified hemoglobin, smoking, hypertension, sex, diabetes, BMI and use of cardiopulmonary bypass (CPB) as significant predictors. Multivariate analysis revealed hemoglobin (OR: 0.8; CI: 0.74-0.86; P<0.001), CPB use (OR: 12.2; CI: 8.2-18.1; P<0.001) and female gender (OR: 2.29; CI:1.72-3.04; P<0.001) as independent risk factors for blood transfusion.
The predictors of RBC transfusion after isolated CABG were performing CPB, preoperative hemoglobin and female gender. These factors can be used as a clinical tool to preserve blood bank resources without increasing patient's risk.
本回顾性研究旨在确定在我们当地心脏外科服务中，预测冠状动脉旁路移植术（CABG）期间患者输血需求的术中特征。
本研究纳入了1835例连续接受冠状动脉旁路移植术的患者，其中男性1311例，女性524例，平均年龄58.8±9.9岁。单因素研究检测到的危险因素被纳入术前变量与输血关系的多因素逻辑回归模型。
435例患者（29.9%）接受了输血。单因素分析确定血红蛋白、吸烟、高血压、性别、糖尿病、体重指数和体外循环（CPB）的使用为显著预测因素。多因素分析显示血红蛋白（比值比：0.8；可信区间：0.74 - 0.86；P<0.001）、CPB的使用（比值比：12.2；可信区间：8.2 - 18.1；P<0.001）和女性性别（比值比：2.29；可信区间：1.72 - 3.04；P<0.001）是输血的独立危险因素。
单纯CABG术后红细胞输血的预测因素是进行CPB、术前血红蛋白和女性性别。这些因素可作为一种临床工具，在不增加患者风险的情况下保存血库资源。
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