Intraoperative/perioperative nonautologous red blood cell transfusion is associated with higher organ system complications in Type A Aortic Dissection repair
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0179
Submission Type:
Abstract Submission
Authors:
Qianyun Luo (1), Renxi Li (2), Stephen Huddleston (1)
Institutions:
(1) University of Minnesota, Minneapolis, MN, (2) The George Washington University, Washington, DC
Submitting Author:
Qianyun Luo
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University of Minnesota
University of Minnesota
Co-Author(s):
Renxi Li
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The George Washington University
The George Washington University
Stephen Huddleston
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University of Minnesota
University of Minnesota
Presenting Author:
Stephen Huddleston
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Abstract:
Objective. Red blood cell (RBC) transfusion has been associated with adverse outcomes in cardiac surgery procedures. However, outcomes in patients having intraoperative/perioperative nonautologous RBC transfusion in patients in Stanford Type A Aortic Dissection (TAAD) repair were less established. This study aimed to conduct a population-based examination of the effect of intraoperative/perioperative nonautologous RBC transfusion on the in-hospital outcomes after TAAD using the National/Nationwide Inpatient Sample (NIS) database.
Methods. Patients who underwent TAAD repair were identified in NIS from the last quarter of 2015-2020. Patients with preoperative RBC transfusion were excluded. Patients with and without intraoperative/perioperative nonautologous RBC transfusion were stratified into two groups. Multivariable logistic regressions, adjusting for demographics, comorbidities, hospital characteristics, primary payer status, and transfer status, were used to compare in-hospital outcomes.
Results. Among all patients who underwent TAAD repair, 1048 (25.28%) patients were included in the transfusion cohort. The transfusion group were more likely to be female, Hispanic, Asian, and have older age, diabetes, depression, renal malperfusion, anemia, thrombocytopenia, and under emergent admission. Patients with and without nonautologous RBC transfusion had comparable in-hospital mortality (16.32% vs 14.47%, aOR=1.113, 95 CI=0.906-1.367, p=0.31). The transfusion group had higher risks of myocardial infarction (7.25% vs 4.91%, aOR=1.492, 95 CI=1.118-1.990, p<0.01), respiratory complications (25.67% vs 20.99%, aOR=1.268, 95 CI=1.073-1.499, p<0.01), mechanical ventilation (39.22% vs 29.93%, aOR=1.448, 95 CI=1.237-1.689, p<0.01), and acute kidney injury (51.81% vs 47.56%, aOR=1.191, 95 CI=1.023-1.386, p=0.02). All other in-hospital complications, hospital length of stay (LOS), and total hospital charge were all comparable between the two groups.
Conclusions. While intraoperative/perioperative nonautologous RBC transfusion was not associated with in-hospital mortality, it was linked to higher risks of major organ system complications. While the causal relationships cannot be established, these findings might be insightful for postoperative management in patients receiving intraoperative/perioperative nonautologous RBC transfusion in TAAD repair.
Methods. Patients who underwent TAAD repair were identified in NIS from the last quarter of 2015-2020. Patients with preoperative RBC transfusion were excluded. Patients with and without intraoperative/perioperative nonautologous RBC transfusion were stratified into two groups. Multivariable logistic regressions, adjusting for demographics, comorbidities, hospital characteristics, primary payer status, and transfer status, were used to compare in-hospital outcomes.
Results. Among all patients who underwent TAAD repair, 1048 (25.28%) patients were included in the transfusion cohort. The transfusion group were more likely to be female, Hispanic, Asian, and have older age, diabetes, depression, renal malperfusion, anemia, thrombocytopenia, and under emergent admission. Patients with and without nonautologous RBC transfusion had comparable in-hospital mortality (16.32% vs 14.47%, aOR=1.113, 95 CI=0.906-1.367, p=0.31). The transfusion group had higher risks of myocardial infarction (7.25% vs 4.91%, aOR=1.492, 95 CI=1.118-1.990, p<0.01), respiratory complications (25.67% vs 20.99%, aOR=1.268, 95 CI=1.073-1.499, p<0.01), mechanical ventilation (39.22% vs 29.93%, aOR=1.448, 95 CI=1.237-1.689, p<0.01), and acute kidney injury (51.81% vs 47.56%, aOR=1.191, 95 CI=1.023-1.386, p=0.02). All other in-hospital complications, hospital length of stay (LOS), and total hospital charge were all comparable between the two groups.
Conclusions. While intraoperative/perioperative nonautologous RBC transfusion was not associated with in-hospital mortality, it was linked to higher risks of major organ system complications. While the causal relationships cannot be established, these findings might be insightful for postoperative management in patients receiving intraoperative/perioperative nonautologous RBC transfusion in TAAD repair.
Aortic Symposium:
Dissection
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