• M Riera, J Ibáñez, M Molina, R Amézaga, A Colomar, A Carrillo, O Bonnín, J I Sáez de Ibarra, and C Campillo-Artero.
• Servicio de Medicina Intensiva, Servicio de Cirugía Cardíaca, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España. Electronic address: rierasagrera@gmail.com.
• Med Intensiva. 2014 Oct 1; 38 (7): 422-9.

ObjectiveA study was made to explore the possible association between the perioperative transfusion of 1 - 2 red blood cell units and in-hospital morbidity, 30-day mortality, and long-term survival in patients undergoing heart surgery.DesignA prospective observational study was carried out.SettingThe ICU of a university hospital.PatientsAll patients over 17 years of age that underwent heart surgery and were admitted to the ICU between November 2002 and December 2009 were included. Those patients who did not (n=703) and those who did (n=959) receive the perioperative transfusion of 1 - 2 red blood cell units were assessed.Study EndpointsThe endpoints were the effect of transfusion on both hospital morbidity and on 30-day mortality. In addition, all patients discharged alive from hospital until 31 December 2011 were subjected to follow-up. The association between transfusion and survival was assessed by means of the Kaplan-Meier method. Cox proportional hazards models were used to assess factors associated with long-term survival.ResultsThe frequency of both cardiac and non-cardiac perioperative complications was higher in patients receiving transfusion. The 30-day mortality rate was higher in those who received transfusion (1% vs 0.1%, P=.02). Preoperative anemia was associated with a more intensive use of transfusion. Red blood cell transfusion was not found to be a risk factor for long-term mortality (hazar ratio=1.4, 95%CI 0.9-2.1).ConclusionsThe perioperative transfusion of 1 - 2 red blood cell units in patients undergoing heart surgery increases both hospital morbidity and the 30-day mortality rate, but does not increase long-term mortality.Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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