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Aim <p>To examine the risk factors for transfusion during isolated off-pump coronary artery bypass grafting (OPCAB) and investigate the differential characteristics among patients receiving single versus multiple blood transfusion units.</p> Methods <p>This retrospective cohort study evaluated patients undergoing isolated OPCAB at a tertiary care centre. Patients were grouped based on whether they received no transfusion, a single unit, or multiple units of blood. Clinical, demographic, and surgical variables were reviewed to assess associations with transfusion requirements. Predictive factors for single- and multiple-unit transfusion were identified through multivariable analysis.</p> Results <p>Compared to patients who required no transfusion, those receiving a single or multiple units were progressively older (56.21 ± 9.1 vs. 58.23 ± 9.03 vs. 60.52 ± 11.67&#xa0;years, <i>p</i> &lt; 0.0001) and had a higher proportion of females (5.8% vs. 7.3% vs. 19.2%, <i>p</i> &lt; 0.0001). Patients who required multiple transfusions underwent more extensive grafting, as reflected by a higher mean number of grafts (2.93 ± 0.91 vs. 3.07 ± 0.90 vs. 3.22 ± 0.85; <i>p</i> &lt; 0.0001), greater drain outputs (604.26 ± 256.05&#xa0;ml vs. 683.02 ± 328.25&#xa0;ml vs. 840.47 ± 613.52&#xa0;ml; <i>p</i> &lt; 0.0001), and higher rates of re-exploration (0.1% vs. 0.6% vs. 5.4%; <i>p</i> &lt; 0.0001).&#xa0;Multivariable analysis identified number of grafts (Odds ratio (OR) 1.58, 95% Confidence interval (CI) 1.45–1.72), female sex (OR 2.95, 95% CI 2.20–3.97), peripheral vascular disease (OR 1.74, 95% CI 1.10–2.74), elevated creatinine (OR 1.34, 95% CI 1.06–1.70), low preoperative haematocrit (OR 0.85, 95% CI 0.84–0.87), and low body mass index (OR 0.93, 95% CI 0.91–0.95) as significant predictors of multiple-unit transfusion. Similar trends were observed for single-unit transfusion, with number of grafts (OR 1.20, 95% CI 1.10–1.31), low haematocrit (OR 0.95, 95% CI 0.93–0.97), and peripheral vascular disease (OR 1.76, 95% CI 1.10–2.82) emerging as significant predictors, while associations with female sex and renal function were not statistically significant.</p> Conclusion <p>A higher number of grafts, low preoperative haematocrit, low body mass index, and peripheral vascular disease were common predictors of both single- and multiple-unit transfusion during OPCAB. In addition, female sex and elevated preoperative creatinine were independently associated with an increased risk of multiple-unit transfusion.</p> Graphical Abstract <p></p>

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Risk factors for blood transfusion in isolated off-pump coronary artery bypass grafting

  • 期刊论文

  • 发表日期：

    2025年8月12日

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  • Apu Saha,
  • Sufina Shales,
  • Shivangi Jain,
  • Susovan Halder,
  • Shubham Gupta,
  • Richa Srivastawa,
  • Digvijay Gowda,
  • Lalit Kapoor,
  • Pradeep Narayan

摘要

Aim

To examine the risk factors for transfusion during isolated off-pump coronary artery bypass grafting (OPCAB) and investigate the differential characteristics among patients receiving single versus multiple blood transfusion units.

Methods

This retrospective cohort study evaluated patients undergoing isolated OPCAB at a tertiary care centre. Patients were grouped based on whether they received no transfusion, a single unit, or multiple units of blood. Clinical, demographic, and surgical variables were reviewed to assess associations with transfusion requirements. Predictive factors for single- and multiple-unit transfusion were identified through multivariable analysis.

Results

Compared to patients who required no transfusion, those receiving a single or multiple units were progressively older (56.21 ± 9.1 vs. 58.23 ± 9.03 vs. 60.52 ± 11.67 years, p < 0.0001) and had a higher proportion of females (5.8% vs. 7.3% vs. 19.2%, p < 0.0001). Patients who required multiple transfusions underwent more extensive grafting, as reflected by a higher mean number of grafts (2.93 ± 0.91 vs. 3.07 ± 0.90 vs. 3.22 ± 0.85; p < 0.0001), greater drain outputs (604.26 ± 256.05 ml vs. 683.02 ± 328.25 ml vs. 840.47 ± 613.52 ml; p < 0.0001), and higher rates of re-exploration (0.1% vs. 0.6% vs. 5.4%; p < 0.0001). Multivariable analysis identified number of grafts (Odds ratio (OR) 1.58, 95% Confidence interval (CI) 1.45–1.72), female sex (OR 2.95, 95% CI 2.20–3.97), peripheral vascular disease (OR 1.74, 95% CI 1.10–2.74), elevated creatinine (OR 1.34, 95% CI 1.06–1.70), low preoperative haematocrit (OR 0.85, 95% CI 0.84–0.87), and low body mass index (OR 0.93, 95% CI 0.91–0.95) as significant predictors of multiple-unit transfusion. Similar trends were observed for single-unit transfusion, with number of grafts (OR 1.20, 95% CI 1.10–1.31), low haematocrit (OR 0.95, 95% CI 0.93–0.97), and peripheral vascular disease (OR 1.76, 95% CI 1.10–2.82) emerging as significant predictors, while associations with female sex and renal function were not statistically significant.

Conclusion

A higher number of grafts, low preoperative haematocrit, low body mass index, and peripheral vascular disease were common predictors of both single- and multiple-unit transfusion during OPCAB. In addition, female sex and elevated preoperative creatinine were independently associated with an increased risk of multiple-unit transfusion.

Graphical Abstract