Newly donated blood reduced complications after cardiac surgery

Patients undergoing cardiac surgery experienced a lower rate of complications when receiving blood donated within 14 days, according to data presented at the Canadian Cardiovascular Congress.

Researchers analyzed patients who underwent non-emergency cardiac surgery and stayed in the hospital for less than 30 days from 2005 to September 2013 at the New Brunswick Heart Centre, Saint John, New Brunswick, Canada.

Patients who received between one and five units of packed red blood cells during the intraoperative or postoperative period were included in the analysis. Patients were stratified into two groups: those who received only blood donated within 14 days of the transfusion (n=1,052; mean units transfused, 1.9) and those who received any blood donated more than 14 days before the procedure (n=963; mean units transfused, 2.3).

Ansar Hassan, MD, PhD, from the department of cardiothoracic surgery at New Brunswick Heart Centre, and colleagues found that patients who received only blood donated within 14 days were more likely to be female, more likely to have unstable angina, more likely to have undergone CABG or valve surgery, more likely to have experienced shorter bypass and cross-clamp times and less likely to be taking intotropes upon leaving the operating room, compared with patients who received at least some older blood.

After adjustment for differences in age, sex and intraoperative characteristics, only blood donated within 14 days was associated with a reduction in the composite outcome of mortality, re-exploration for bleeding, ventilation longer than 24 hours, infection, atrial fibrillation and renal failure (OR=0.79; 95% CI, 0.65-0.95).

Compared with those receiving at least some older blood, patients who received only newer blood had lower rates of mortality (1.7% vs. 3.3%; P=.02), re-exploration for bleeding (1.5% vs. 3.1%; P=.02), prolonged ventilation (3% vs. 7.7%; P<.0001), infection (3.2% vs. 5.4%; P=.02), renal failure (12.8% vs. 17.7%, P=.003) and mean length of stay (6.6 days vs. 7.9 days; P<.0001). The researchers found no difference between the groups in AF (43.8% vs. 47.3%; P=.12).

“The findings show that we need to pay attention to the age of the blood we give cardiac surgery patients,” Hassan said in a press release. He noted that cardiac surgeries should not be postponed if newer blood is not available. “Perhaps more importantly, we need new studies to determine what is driving this relationship between the age of blood and the outcomes we are seeing.”

For more information:

White A. Abstract #562. Presented at: Canadian Cardiovascular Congress; Oct. 25-28, 2014; Vancouver, British Columbia.

Disclosure: Hassan reports no relevant financial disclosures.