Implications of Transfusion in Adults with Congenital Heart Disease Undergoing Cardiac Surgery.
Pediatr Cardiol
; 44(1): 218-227, 2023 Jan.
Article
em En
| MEDLINE
| ID: mdl-35963890
ABSTRACT
The number of adults with congenital heart disease (CHD) requiring cardiovascular (CV) surgery is increasing rapidly in today's era. We hypothesized that exposure to perioperative blood products is associated with worse outcomes in adults. All adults (≥ 18 years old) undergoing CV surgery with Cardio-Pulmonary Bypass (CPB) between 2015 and 2020 were reviewed retrospectively. Associations between transfusion and outcomes were studied by univariable logistic regression and Wilcoxon rank sum tests. Cox/ logistic regression was used to assess (a) postoperative ventilation time and length of stay, and (b) major complications, respectively. Of 323 patients, 170 (53%) received blood products perioperatively. The median age was 27 (interquartile range [IQR] 22-36) years, there were 181 (46%) males, and 16 (5%) patients had single ventricle anatomy. Patients receiving products experienced more complications (OR 6.6, 95% CI [2.9, 14.7], p < 0.001) specifically, cardiac arrest (OR 8.8, 95% CI [1.1, 71.9], p = 0.04). Transfusion was associated with greater frequency of thrombosis ((OR 7.8, 95% CI [1.8, 34.7], p = 0.01)), longer ventilation time (HR 3.0, 95% CI [2.4, 3.9], p < 0.001), and longer hospital length of stay (HR 2.7, 95% CI [2.1, 3.4], p < 0.001). Longer CPB time (OR 1.0, 95% CI [1.0, 1.1], p < 0.001) and prior cardiac surgery (OR 1.6, 95% CI [1.3, 2.1], p < 0.001) were independent predictors of perioperative blood product transfusion. Adults who received perioperative blood products experienced more complications and worse in-hospital outcomes. Future research on optimizing blood product transfusion based on risk prediction is needed to optimize outcomes in adults with CHD.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cardiopatias Congênitas
/
Procedimentos Cirúrgicos Cardíacos
Tipo de estudo:
Prognostic_studies
Limite:
Adolescent
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Adult
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Female
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Humans
/
Male
Idioma:
En
Revista:
Pediatr Cardiol
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos