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Platelet transfusions are not associated with increased morbidity or mortality in cardiac surgery

La transfusion de plaquettes n’est pas associée à une hausse de la morbidité ou de la mortalité en cardiochirurgie

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Abstract

Purpose

To determine the independent relationship between leukoreduced platelet transfusions and adverse events in cardiac surgery.

Methods

In this observational study, detailed baseline and perioperative data were prospectively collected on consecutive patients who underwent cardiac surgery at a single institution from 1999 to 2004. The independent associations of platelet transfusion with clinical outcomes (low output syndrome, myocardial infarction, stroke, renal failure, sepsis, and death) were determined by multivariable logistic regression analysis and propensity score case-control analysis.

Results

Of the 11,459 patients analyzed, 2,174 (19%) received (leukoreduced) platelets -1,408 received 5 U, 471 received 10 U, 140 received 15 U, and 155 received 20 or more units. Although all measured adverse event rates were higher in those who received platelets, in neither the logistic regression analyses nor the propensity score analyses was there any association between platelet transfusion and any of the adverse events.

Conclusions

Transfusion of leukoreduced platelets in cardiac surgery is not associated with adverse clinical outcomes when adjustments are made for important confounders.

Résumé

Objectif

Déterminer la relation indépendante entre la transfusion de plaquettes réduites en leucocytes et les événements indésirables en cardiochirurgie.

Méthode

Dans une étude par observation, la cueillette prospective des données initiales et périopératoires détaillées a été faite pour des patients successivement opérés en cardiochirurgie dans un seul établissement entre 1999 et 2004. Les associations indépendantes entre transfusion plaquettaire et résultat clinique (syndrome de bas débit, infarctus du myocarde, accident vasculaire, insuffisance rénale, septicémie et mort) ont été déterminées par une analyse multivariée de régression logistique et une analyse cas-témoins du score de propension.

Résultats

Des 11 459 patients analysés, 2 174 (19 %) ont reçu des plaquettes réduites en leucocytes -1 408 ont eu 5 U, 471 ont eu 10 U, 140 ont eu 15 U et 155 ont eu 20 unités ou plus. Tous les taux ďévénements indésirables mesurés étaient plus élevés chez ceux qui avaient reçu des plaquettes, mais ni éanalyse de régression logistique ni éanalyse du score de propension n’ont montré ďassociation entre la transfusion de plaquettes et éun des événements indésirables.

Conclusion

En cardiochirurgie, la transfusion de plaquettes réduites en leucocytes n’est pas associée à des complications cliniques quand ďimportants facteurs de confusion sont corrigés.

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Authors and Affiliations

  1. Departments of Anesthesia, University Health Network, University of Toronto, Toronto, Ontario, Canada

    Keyvan Karkouti, Duminda N Wijeysundera, Massimiliano Meineri, Marcin Wasowicz, Stuart A McCluskey & W. Scott Beattie

  2. Department of Health Policy, Management, and Evaluation, University Health Network, University of Toronto, Toronto, Ontario, Canada

    Keyvan Karkouti

  3. Departments of Cardiac Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada

    Terrence M Yau

  4. Departments of Haematology, University Health Network, University of Toronto, Toronto, Ontario, Canada

    Jeannie L Callum

Authors
  1. Keyvan Karkouti
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  2. Duminda N Wijeysundera
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  3. Terrence M Yau
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  4. Jeannie L Callum
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  5. Massimiliano Meineri
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  6. Marcin Wasowicz
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  7. Stuart A McCluskey
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  8. W. Scott Beattie
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Correspondence to Keyvan Karkouti.

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Karkouti, K., Wijeysundera, D.N., Yau, T.M. et al. Platelet transfusions are not associated with increased morbidity or mortality in cardiac surgery. Can J Anesth 53, 279–287 (2006). https://doi.org/10.1007/BF03022216

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  • DOI: https://doi.org/10.1007/BF03022216

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