The Impact of Blood Conservation on Outcomes in Cardiac Surgery: Is It Safe and Effective?

摘要: Background Increasing evidence shows that perioperative blood transfusion in cardiac surgery is associated with increased postoperative morbidity and mortality decreased long-term survival. Tolerance of "permissive anemia" an important element conservation strategy. The safety tolerating anemia has been a significant deterrent for widespread application conservation. This study examines whether equally safe or superior to the common practice surgery. Methods total population consisted 32,449 patients who underwent isolated coronary artery bypass from June 2000 until December 2004 complete data 17 institutions State New Jersey. Englewood Hospital Medical Center (EH) well-established program. Five hundred eighty-six EH (blood cohort) were compared propensity score–matched cohort 586 other Jersey (OH-M) representing transfusion. Outcomes classified as very serious complications, neither (no complication complication). Analysis McNemar tests multiple logistic regression. Results Fewer transfused at OH-M (10.6% versus 42.5%; p = 0.02). Of patients, 11.1% experienced 18.7% ( 0.0002). Transfusion was risk adverse outcome both cohorts (EH: odds ratio, 7.3; 95% confidence interval, 3.7 14.4 OH-M: 4.6; 2.8 7.7). Conclusions Blood effective reducing transfusions. anemia, which one main components conservation, does not increase complications death Avoidance reduces complications. further solidifies relationship between