TY - JOUR
T1 - Transfusion practice in coronary artery bypass surgery in Denmark
T2 - a multicenter audit
AU - Andreasen, Jan J.
AU - Westen, Mikkel
AU - Pallesen, Peter Appel
AU - Jensen, Søren
AU - Gorst-Rasmussen, Anders
AU - Johnsen, Søren P.
PY - 2007/10/1
Y1 - 2007/10/1
N2 - Transfusion rates in coronary artery bypass grafting (CABG) continue to vary substantially, although guidelines for allogeneic transfusion have been developed. In order to evaluate ongoing transfusion practices, we performed a multicenter audit in four Danish hospitals regarding the use of allogeneic blood products among patients undergoing first-time CABG. Data on patient characteristics, peri- and postoperative factors were retrieved from 600 patient records (150 records per hospital). Substantial differences were seen regarding preoperative intake of antiplatelet drugs, perioperative use of antifibrinolytic drugs, use of cardiopulmonary bypass (CPB), cross-clamp time, time on CPB, lowest hemoglobin during CPB, and number of distal anastomoses. The percentage of patients transfused with allogeneic red blood cells ranged from 30.0% to 64.2%. Several patients (12.1-42.7%) transfused with red blood cells were discharged with a hemoglobin concentration >7 mmol/l, indicating inappropriate transfusions. The relative risk of receiving an allogeneic blood transfusion was 2.1 (95% CI: 1.6-2.7) in the hospital with the highest transfusion rate, after adjustment for patient-, drug-, and procedure-related factors. Interesting differences in transfusion rates exists in Danish hospitals and these differences may reflect true variations in transfusion practices. Audits create a basis for educational efforts among surgeons and anesthesiologists to standardize transfusion practices
AB - Transfusion rates in coronary artery bypass grafting (CABG) continue to vary substantially, although guidelines for allogeneic transfusion have been developed. In order to evaluate ongoing transfusion practices, we performed a multicenter audit in four Danish hospitals regarding the use of allogeneic blood products among patients undergoing first-time CABG. Data on patient characteristics, peri- and postoperative factors were retrieved from 600 patient records (150 records per hospital). Substantial differences were seen regarding preoperative intake of antiplatelet drugs, perioperative use of antifibrinolytic drugs, use of cardiopulmonary bypass (CPB), cross-clamp time, time on CPB, lowest hemoglobin during CPB, and number of distal anastomoses. The percentage of patients transfused with allogeneic red blood cells ranged from 30.0% to 64.2%. Several patients (12.1-42.7%) transfused with red blood cells were discharged with a hemoglobin concentration >7 mmol/l, indicating inappropriate transfusions. The relative risk of receiving an allogeneic blood transfusion was 2.1 (95% CI: 1.6-2.7) in the hospital with the highest transfusion rate, after adjustment for patient-, drug-, and procedure-related factors. Interesting differences in transfusion rates exists in Danish hospitals and these differences may reflect true variations in transfusion practices. Audits create a basis for educational efforts among surgeons and anesthesiologists to standardize transfusion practices
KW - Aged
KW - Anastomosis, Surgical
KW - Antifibrinolytic Agents
KW - Blood Component Transfusion
KW - Blood Loss, Surgical
KW - Cardiopulmonary Bypass
KW - Coronary Artery Bypass
KW - Coronary Artery Disease
KW - Denmark
KW - Female
KW - Hemoglobins
KW - Humans
KW - Male
KW - Medical Audit
KW - Middle Aged
KW - Odds Ratio
KW - Platelet Aggregation Inhibitors
KW - Practice Guidelines as Topic
KW - Quality of Health Care
KW - Retrospective Studies
KW - Risk Assessment
KW - Time Factors
U2 - 10.1510/icvts.2007.154401
DO - 10.1510/icvts.2007.154401
M3 - Journal article
C2 - 17670734
SN - 1569-9293
VL - 6
SP - 623
EP - 627
JO - Interactive Cardiovascular and Thoracic Surgery
JF - Interactive Cardiovascular and Thoracic Surgery
IS - 5
ER -