Introduction of universal prestorage leukodepletion of blood components, and outcomes in transfused cardiac surgery patients
MetadataShow full item record
Objective: To assess whether introduction of universal leukodepletion (ULD) of red blood cells (RBCs) for transfusion was associated with improvements in cardiac surgery patient outcomes.Methods: Retrospective study (2005-2010) conducted at 6 institutions. Associations between leukodepletion and outcomes of mortality, infection, and acute kidney injury (AKI) were modeled by logistic regression, and intensive care unit length of stay (LOS) in survivors was explored using linear regression. To examine trends over time, odds ratios (ORs) for outcomes of transfused were compared with nontransfused patients, including a comparison with nontransfused patients who were selected based on propensity score for RBC transfusion. Results: We studied 14,980 patients, of whom 8857 (59%) had surgery pre-ULD. Transfusions of RBCs were made in 3799 (43%) pre-ULD, and 2525 (41%) post-ULD. Administration of exclusively leukodepleted, versus exclusively nonleukodepleted, RBCs was associated with lower incidence of AKI (adjusted OR 0.80, 95% confidence interval [CI] 0.65-0.98, P = .035), but no difference in mortality or infection. For post-ULD patients, no difference was found in mortality (OR 0.96, 95% CI 0.76-1.22, P = .76) or infection (OR 0.91, 95% CI 0.79-1.03, P = .161); however, AKI was reduced (OR 0.79 95% CI 0.68-0.92, P = .003). However, ORs for post-ULD outcomes were not significantly different in nontransfused, versus transfused, patients. Furthermore, those who received exclusively nonleukodepleted RBCs were more likely to have surgery post-ULD.Conclusions: Universal leukodepletion was not associated with reduced mortality or infection in transfused cardiac surgery patients. An association was found between ULD and reduced AKI; however, this reduction was not significantly different from that seen in nontransfused patients, and other changes in care most likely explain such changes in renal outcomes.
Showing items related by title, author, creator and subject.
Gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort studyGombotz, H.; Schreier, G.; Neubauer, S.; Kastner, P.; Hofmann, Axel (2016)Objectives: A post hoc gender comparison of transfusion-related modifiable risk factors among patients undergoing elective surgery. Settings: 23 Austrian centres randomly selected and stratified by region and level of ...
Sex differences in outcomes following isolated coronary artery bypass graft surgery in Australian patients: Analysis of the Australasian Society of Cardiac and Thoracic Surgeons cardiac surgery databaseSaxena, A.; Dinh, D.; Smith, J.; Shardey, G.; Reid, Christopher; Newcomb, A. (2012)Objectives: Women undergoing isolated coronary artery bypass graft (CABG) surgery have been previously shown to be at an independently increased risk for post-operative morbidity and mortality. The current study evaluates ...
Predictors of perioperative blood transfusions in patients with chronic kidney disease undergoing elective knee and hip arthroplastyGraves, A.; Yates, P.; Hofmann, Axel; Farmer, Shannon; Ferrari, P. (2014)Background: Lower preoperative haemoglobin and older age pose a risk for perioperative allogeneic blood transfusions (ABT). The presence of chronic kidney disease (CKD) is associated with low haemoglobin, greater bleeding ...