Abstract：
BACKGROUND: The objective of this single-center study it to retrospectively analyze the relationship between transfusion and 30-day postoperative outcomes in patients undergoing isolated off-pump coronary artery bypass grafting.
METHODS: Perioperative data of 2,178 patients who underwent isolated off-pump coronary artery bypass grafting from 2018 to 2019 were collected. A 1:1 propensity score matching was performed to control for potential biases between patients who received blood transfusion and those who did not. After propensity score matching, we analyzed the clinical outcomes of transfusion and non-transfusion patients. Postoperative complications and the survival of patients within 30 days after surgery in both groups were analyzed. Kaplan-Meier survival curve and log-rank test were used for survival analysis.
RESULTS: The total blood transfusion rate of all patients was 29%, including red blood cell (27.6%), plasma (7.3%), and platelet (1.9%). Four hundred and forty patients in each group were compared after propensity score matching. There were no significant differences in the incidence of stroke, myocardial infarction, atrial fibrillation, acute kidney function injury, and sternal wound infection of both groups (P>0.05). However, higher incidence of postoperative pulmonary infection and more mechanical ventilation time and days of stay in the intensive care unit and postoperative in-hospital stay were associated with blood transfusion (P<0.05). The 30-day cumulative survival rate of the transfusion group was lower than that of the control group (P<0.05).
CONCLUSIONS: Perioperative blood transfusion increases the risks of postoperative pulmonary infection and short-term mortality in off-pump coronary artery bypass grafting patients.
METHODS: Perioperative data of 2,178 patients who underwent isolated off-pump coronary artery bypass grafting from 2018 to 2019 were collected. A 1:1 propensity score matching was performed to control for potential biases between patients who received blood transfusion and those who did not. After propensity score matching, we analyzed the clinical outcomes of transfusion and non-transfusion patients. Postoperative complications and the survival of patients within 30 days after surgery in both groups were analyzed. Kaplan-Meier survival curve and log-rank test were used for survival analysis.
RESULTS: The total blood transfusion rate of all patients was 29%, including red blood cell (27.6%), plasma (7.3%), and platelet (1.9%). Four hundred and forty patients in each group were compared after propensity score matching. There were no significant differences in the incidence of stroke, myocardial infarction, atrial fibrillation, acute kidney function injury, and sternal wound infection of both groups (P>0.05). However, higher incidence of postoperative pulmonary infection and more mechanical ventilation time and days of stay in the intensive care unit and postoperative in-hospital stay were associated with blood transfusion (P<0.05). The 30-day cumulative survival rate of the transfusion group was lower than that of the control group (P<0.05).
CONCLUSIONS: Perioperative blood transfusion increases the risks of postoperative pulmonary infection and short-term mortality in off-pump coronary artery bypass grafting patients.
摘要：
背景：这项单中心研究的目的是回顾性分析接受非体外循环冠状动脉旁路移植术的患者输血与术后30天预后之间的关系。
方法：收集了2018年至2019年接受孤立性非体外循环冠状动脉旁路移植术的2,178例患者的围手术期数据。进行1：1倾向评分匹配以控制接受输血的患者与未接受输血的患者之间的潜在偏见。在倾向得分匹配后，我们分析了输血和非输血患者的临床结局.分析两组患者术后并发症及术后30d内生存情况。采用Kaplan-Meier生存曲线和对数秩检验进行生存分析。
结果：所有患者的总输血率为29%，包括红细胞（27.6%），血浆（7.3%），和血小板(1.9%)。在倾向评分匹配后，对每组40例患者进行比较。中风的发生率没有显着差异，心肌梗塞,心房颤动,急性肾功能损伤，胸骨切口感染两组比较差异无统计学意义(P>0.05)。然而,术后肺部感染发生率较高,机械通气时间、重症监护病房住院天数和术后住院天数均与输血有关(P<0.05)。输血组30d累积生存率低于对照组(P<0.05)。
结论：围手术期输血会增加非体外循环冠状动脉旁路移植术患者术后肺部感染和短期死亡率的风险。
方法：收集了2018年至2019年接受孤立性非体外循环冠状动脉旁路移植术的2,178例患者的围手术期数据。进行1：1倾向评分匹配以控制接受输血的患者与未接受输血的患者之间的潜在偏见。在倾向得分匹配后，我们分析了输血和非输血患者的临床结局.分析两组患者术后并发症及术后30d内生存情况。采用Kaplan-Meier生存曲线和对数秩检验进行生存分析。
结果：所有患者的总输血率为29%，包括红细胞（27.6%），血浆（7.3%），和血小板(1.9%)。在倾向评分匹配后，对每组40例患者进行比较。中风的发生率没有显着差异，心肌梗塞,心房颤动,急性肾功能损伤，胸骨切口感染两组比较差异无统计学意义(P>0.05)。然而,术后肺部感染发生率较高,机械通气时间、重症监护病房住院天数和术后住院天数均与输血有关(P<0.05)。输血组30d累积生存率低于对照组(P<0.05)。
结论：围手术期输血会增加非体外循环冠状动脉旁路移植术患者术后肺部感染和短期死亡率的风险。
