Identifying Patients at Risk of Postoperative Bleeding in Open Heart Surgery in King Abdul Aziz University Hospital
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- Category: Vol. 77, September 2009
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Identifying Patients at Risk of Postoperative Bleeding in Open Heart Surgery in King Abdul
Aziz University Hospital,SALWA HINDAWI, GALILA ZAHER, GHAZI DAMANHORI, SAMY MAROUF, RAGAB SHEHATA, KHALED AL-EBRAHIM and HUSAIN JABBAD
Abstract
Background: In cardiac surgery, excessive blood loss requiring large volume red blood cells (RBCs) is associated with significant morbidity and mortality. There are different variables affecting large volume RBCs transfusion in open heart surgery. The objective of this study is to review trans-fusion practice in open heart surgery in King Abdul Aziz University Hospital (KAUH) and the risk factors for excessive blood loss and therefore transfusion.
Patients and Methods: Data were retrospectively collected on 115 cardiac surgical patients during 2005-2007. The risk factors for large-volume (>4 units) RBCs transfusion were calculated and compared with non or low transfused patients. The risk factors for large volume RBCs transfusion were determined.
Results: Large-volume RBCs transfusion >4 units has occurred in 35 (30.4%) patients while 49 (42.6%) were none transfused and 31 (26.95%) received from 1 to 4 units. On analysis of preoperative Hgb of the studied group there was 56 (48.6%) patients were anemic and 59 patients (51.3%) have normal Hgb and there was highly significant difference in the number of PRBCs units transfusion in anemic group on comparison with non anemic group (p<001) and also in patients underwent urgent operation (20 patients, 17.3%) Vs elective surgery (95 patients, 82.6%) (p<0.002), DM patients (19 patients, 16.5%) Vs non diabetic patients (96 patients, 83.4%) (p<0.005). There was positive correlation between number of PRBCs units transfused and increasing age (p=.009) while there was non significant difference in number of PRBCs transfusion in patients with coronary artery bypassing graft (CABG) in comparison with multiple valve replacement (p=0.488) and male patients Vs female (p=0.09).
Conclusion: This study confirmed that a high-risk group of patients exists in open heart surgery. Low preoperative hemoglobin, DM, old age and urgent surgical intervention are at higher risk for large-volume blood transfusion while the type of operation or patients sex has non significant risk.