From the Literature

 

Published: Oct 2019

Transfusion timing and postoperative myocardial infarction and death in patients undergoing common vascular procedures.
Heafner T, Bews K, Kalra M, et al.
Ann Vasc Surg 2019; Oct 15 [Epub ahead of print].
Pub Med
NATA rating :

 

REVIEW by:
M. T. Prochaska

 

NATA REVIEW:
This study aimed to evaluate the association of transfusion timing (intraoperative versus postoperative) on the rate of postoperative myocardial infarction and death after common inpatient vascular surgery procedures. The authors wanted to evaluate this association because, although perioperative transfusions have been associated with increased mortality, in some cases (significant blood loss) they can be life-saving and the timing of the transfusion may be a marker of the necessity for a life-saving transfusion.

The study was a retrospective review of data collected by the Society of Vascular Surgery. There were 1154 total operations included in the analysis, including the following procedures: endovascular aneurysm repair, infra-inguinal bypasses, open abdominal aortic aneurysms, supra-inguinal bypasses, thoracic endovascular aortic repair, and inpatient peripheral vascular interventions. The primary outcome of the study was postoperative myocardial infarction and the secondary outcome was 30-day all-cause mortality.

The authors found that receiving both intraoperative and postoperative transfusion or postoperative transfusion only compared to no transfusion was associated with higher odds of postoperative myocardial infarction; however, intraoperative transfusion only was not. They also found that any intraoperative or postoperative transfusion compared to no transfusion was not associated with mortality.

The authors conclude that the perioperative setting of transfusion is important in its impact on postoperative outcomes and needs to be accounted for when evaluating transfusion outcomes and indications.


– Micah T. Prochaska (SABM reviewer)