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Ann Thorac Surg 1985;40:380-384
© 1985 The Society of Thoracic Surgeons

Articles

Determinants of Blood Utilization during Myocardial Revascularization

Delos M. Cosgrove, M.D.*, Floyd D. Loop, M.D., Bruce W. Lytle, M.D., Carl C. Gill, M.D., Leonard R. Golding, M.D., Paul C. Taylor, M.D., Sarah B. Forsythe, M.S.

From the Department of Thoracic and Cardiovascular Surgery and the Department of Biostatistics, The Cleveland Clinic Foundation, Cleveland, OH.

Accepted for publication January 11, 1985.

* Address reprint requests to Dr. Cosgrove, The Cleveland Clinic Foundation, Department of Thoracic and Cardiovascular Surgery, 9500 Euclid Ave, Cleveland, OH 44106

Blood transfusion during cardiac surgical procedures has steadily decreased, but little information is available regarding the factors that determine its necessity or amount. To determine the predictors of blood utilization during myocardial revascularization, 441 consecutive patients undergoing primary myocardial revascularization were studied. Forty-four patients (10%) received blood during hospitalization with a mean transfusion of 0.3 ± 1.4 units per patient. Age, sex, weight, body surface area, preoperative hematocrit, blood volume, and red blood cell volume were examined univariately for trends. All demonstrated a statistically significant trend for both need and amount of transfusion (p < 0.001). Neither number of grafts nor duration of cardiopulmonary bypass demonstrated statistically significant trends. All univariately significant factors were evaluated by multivariate logistic regression analysis. Red cell volume was the best predictor of the need for transfusion (p < 0.001), followed by age. No other factors improved predictive capabilities. We conclude that preoperative red cell mass and age are the principal determinants of the need for and quantity of blood transfused during myocardial revascularization. Use of this information may greatly improve the efficiency of ordering blood before operation.




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