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Predictors of massive transfusion with thoracic aortic procedures involving deep hypothermic circulatory arrest.

Publication ,  Journal Article
Williams, JB; Phillips-Bute, B; Bhattacharya, SD; Shah, AA; Andersen, ND; Altintas, B; Lima, B; Smith, PK; Hughes, GC; Welsby, IJ
Published in: J Thorac Cardiovasc Surg
May 2011

OBJECTIVE: Massive perioperative blood product transfusion may be required with thoracic aortic operations and is associated with poor outcomes. We analyzed independent predictors of massive transfusion in thoracic aortic surgical patients undergoing deep hypothermic circulatory arrest. METHODS: The study consisted of 168 consecutive patients undergoing open thoracic aortic procedures involving deep hypothermic circulatory arrest between July 2005 and August 2008. We identified 26 preoperative and procedural variables as potentially related to blood product use, tested for association with total blood products transfused by multivariate linear regression model, and constructed logistic regression model for massive transfusion (requiring ≥ 5 units of transfused packed red blood cells between incision and 48 postoperative hours). RESULTS: Multivariate linear regression determined that 6 significant variables accounted for 42% of variation in total blood products transfused: age (P = .008), preoperative hemoglobin (P = .04), weight (P = .02), cardiopulmonary bypass time (P < .0001), emergency status (P < .0001), and resternotomy (P < .0001). Final predictive logistic regression model included 1-g/dL increase in preoperative hemoglobin (odds ratio, 0.54; 95% confidence interval, 0.43-0.69; P < .0001), 10-minute increase in cardiopulmonary bypass time (odds ratio, 1.15; 95% confidence interval, 1.05-1.26; P = .0026), and emergency status (odds ratio, 4.02; 95% confidence interval, 1.53-10.55; P = .0047. CONCLUSIONS: Cardiopulmonary bypass time, emergency status, and preoperative hemoglobin were independent predictors of massive transfusion. These variables, along with weight, age, and resternotomy, were associated with total blood product use in thoracic aortic operations involving deep hypothermic circulatory arrest.

Duke Scholars

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

May 2011

Volume

141

Issue

5

Start / End Page

1283 / 1288

Location

United States

Related Subject Headings

  • Vascular Surgical Procedures
  • Time Factors
  • Sternotomy
  • Risk Factors
  • Risk Assessment
  • Respiratory System
  • Reoperation
  • Registries
  • Postoperative Hemorrhage
  • Odds Ratio
 

Citation

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MLA
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Williams, J. B., Phillips-Bute, B., Bhattacharya, S. D., Shah, A. A., Andersen, N. D., Altintas, B., … Welsby, I. J. (2011). Predictors of massive transfusion with thoracic aortic procedures involving deep hypothermic circulatory arrest. J Thorac Cardiovasc Surg, 141(5), 1283–1288. https://doi.org/10.1016/j.jtcvs.2010.07.098
Williams, Judson B., Barbara Phillips-Bute, Syamal D. Bhattacharya, Asad A. Shah, Nicholas D. Andersen, Burak Altintas, Brian Lima, Peter K. Smith, G Chad Hughes, and Ian J. Welsby. “Predictors of massive transfusion with thoracic aortic procedures involving deep hypothermic circulatory arrest.J Thorac Cardiovasc Surg 141, no. 5 (May 2011): 1283–88. https://doi.org/10.1016/j.jtcvs.2010.07.098.
Williams JB, Phillips-Bute B, Bhattacharya SD, Shah AA, Andersen ND, Altintas B, et al. Predictors of massive transfusion with thoracic aortic procedures involving deep hypothermic circulatory arrest. J Thorac Cardiovasc Surg. 2011 May;141(5):1283–8.
Williams, Judson B., et al. “Predictors of massive transfusion with thoracic aortic procedures involving deep hypothermic circulatory arrest.J Thorac Cardiovasc Surg, vol. 141, no. 5, May 2011, pp. 1283–88. Pubmed, doi:10.1016/j.jtcvs.2010.07.098.
Williams JB, Phillips-Bute B, Bhattacharya SD, Shah AA, Andersen ND, Altintas B, Lima B, Smith PK, Hughes GC, Welsby IJ. Predictors of massive transfusion with thoracic aortic procedures involving deep hypothermic circulatory arrest. J Thorac Cardiovasc Surg. 2011 May;141(5):1283–1288.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

May 2011

Volume

141

Issue

5

Start / End Page

1283 / 1288

Location

United States

Related Subject Headings

  • Vascular Surgical Procedures
  • Time Factors
  • Sternotomy
  • Risk Factors
  • Risk Assessment
  • Respiratory System
  • Reoperation
  • Registries
  • Postoperative Hemorrhage
  • Odds Ratio