Abstract
Introduction
Blood loss following cardiac surgery is a recognised complication associated with post-operative mortality and morbidity.
Aim
To identify parameters associated with blood loss and need for blood transfusion following first time coronary-artery-bypass-graft (CABG).
Method
Data was collected retrospectively on 50 patients who underwent a first time CABG between 12/02/2020 – 21/09/2020 at the Golden Jubilee National Hospital (GJNH). Parameters included pre-operative and post-operative haemoglobin, platelets, INR, calcium levels, patient age, body-mass-index (BMI), creatinine clearance (CrCl), presence of co-morbidities, anti-coagulant drug use, cross-clamp time, bypass time, re-exploration rates and number of grafts. Patients who required a blood transfusion post-operatively were compared with those who did not require transfusion.
Results
Seventeen of the 50 patients required a blood transfusion. This group had a lower mean post-operative haemoglobin levels (90.82 vs 107.82, p = <0.001), lower mean post-operative platelet levels (138.47 vs 187.09, p = 0.02), higher post-operative INR (1.25 vs 1.15, p = 0.15), higher mean BMI (27.93 vs 30.433, p = 0.063), higher mean renal dysfunction severity grades (0.7 vs 0.3, p = 0.044) and lower mean CrCl (78 vs 97, p = 0.025). The transfused patient group had older mean age (68.29 vs 64.84, p = 0.065) and a longer mean post-operative hospital stay (9.38 vs 6.67 days, p = 0.043). More patients had pre-operative haemoglobin <120 (p = 0.26), post-operative haemoglobin <90 (p = <0.0001) and post-operative platelets <100 (p = 0.0029). One patient in the transfused group died post-operatively.
Conclusions
Sub-optimal peri-operative blood levels, renal dysfunction, patient age and patient BMI can influence blood loss and requirement for transfusion following first time CABG.
Variation in Use of Blood Transfusion in Coronary Artery Bypass Graft Surgery