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Title: Association of perioperative cryoprecipitate transfusion and mortality after cardiac surgery.
Austin Authors: Hinton, Jake V;Xing, Zhongyue;Fletcher, Calvin M;Perry, Luke A;Karamesinis, Alexandra;Shi, Jenny;Ramson, Dhruvesh M;Penny-Dimri, Jahan C;Liu, Zhengyang;Williams-Spence, Jenni;Coulson, Tim G ;Smith, Julian A;Segal, Reny;Bellomo, Rinaldo 
Affiliation: Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Australia.
Department of Anaesthesiology and Perioperative Medicine, The Alfred Hospital and Monash University, Melbourne, Australia.
Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Australia.
Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia; Department of Cardiothoracic Surgery, Monash Health, Clayton, Australia.
Department of Critical Care, The University of Melbourne, Parkville, Australia.
Australian and New Zealand Intensive Care Research Centre, Monash University, Clayton, Australia; Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia.
Intensive Care
Issue Date: Aug-2023
Date: 2023
Publication information: The Annals of Thoracic Surgery 2023-08; 116(2)
Abstract: Cryoprecipitate is often transfused in patients undergoing cardiac surgery. However, its safety and effectiveness remains uncertain. We conducted a propensity-score matched analysis of data from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database. We included adults undergoing cardiac surgery between 2005-2018 across 38 sites. We estimated the association between perioperative cryoprecipitate transfusion and clinical outcomes, with a primary outcome of operative mortality. Of 119,132 eligible patients, 11,239 (9.43%) patients received cryoprecipitate. The median cumulative dose was 8 units (interquartile range, 5 to 10). After propensity-score matching, we matched 9,055 cryoprecipitate recipients to 9,055 controls. Postoperative cryoprecipitate transfusion was associated with reduced operative (Odds Ratio [OR], 0.82; 99% confidence interval [CI], 0.69 to 0.97; P=0.002) and long term (Hazard Ratio, 0.92; 99% CI, 0.87 to 0.97; P=0.0042) mortality. It was also associated with a reduction in acute kidney injury (OR, 0.85; 99% CI, 0.73 to 0.98; P=0.0037] and all-cause infection (OR, 0.77; 99% CI, 0.67 to 0.88; P<0.0001). These findings were observed despite increased rates of return to operating theatre (OR, 1.36; 99% CI, 1.22 to 1.51; P<0.0001) and cumulative 4-hour postoperative chest tube output (Adjusted Mean Difference in mL, 97.69; 99% CI, 81.65 to 113.74; P<0.0001). In a large, multicentre cohort study and after propensity-score matching, perioperative transfusion of cryoprecipitate was associated with reduced operative and long-term mortality.
DOI: 10.1016/j.athoracsur.2023.02.054
Journal: The Annals of Thoracic Surgery
PubMed URL: 36914040
ISSN: 1552-6259
Type: Journal Article
Appears in Collections:Journal articles

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