Packed Red Blood Cell Transfusion in Elective Coronary Artery bypass Graft Surgery in Siriraj Hospital

Abstract

Background: Coronary bypass graft surgery (CABGs) is considered to be an operation with high rate of packed red blood cell (PRBC) transfusion. The aim of this prospective obser - vational study is to evaluate the prevalence and risk factors of PRBC  transfusion in elective CABGs in Siriraj Hospital.

Study design and Method: Between November 2011 - September 2013, a prospective observational study was conducted and 300 patients undergoing isolated, first time CABG were enrolled. Patients’ preoperative variables and postoperative outcomes, as well as perioperative transfusion characteristics were recorded.

Results: A total of 300 patients were enrolled in the study. Overall, PRBC transfusion was utilized in 291 patients (97%). Two hundred and forty of these patients (80%) received PRBC more than 2 units. Univariate analysis identified female gender, age > 65 years, BMI < 30 kg/m2, NYHA class 3-4, diabetic mellitus, hypertension, preoperative hemoglobin concen-tration < 12 g/dl, and creatinine clearance < 60 ml/min as significant predictors of PRBC transfusion > 2 units. The result of multivariate analysis showed BMI < 30 kg/m2, NYHA class 3-4, diabetic mellitus and preoperative hemoglobin < 12 g/dl were significant predictors of PRBC transfusion > 2 units.

Conclusions: Transfusion rate for CABG patients in our institute is high. As BMI < 30 kg/m2, NYHA class ≥ 3, diabetic mellitus, and preoperative hemoglobin < 12 g/dl turned out to be the most significant predictors of red cell transfusion, almost all patients had at least one of these features.