TY - JOUR
T1 - Red Cell Transfusion is Associated With an Increased Risk for Postoperative Atrial Fibrillation
AU - Koch, Colleen Gorman
AU - Li, Liang
AU - Van Wagoner, David R.
AU - Duncan, Andra I.
AU - Gillinov, A. Marc
AU - Blackstone, Eugene H.
N1 - Funding Information:
This work was supported in part by a grant from the State of Ohio’s Third Frontier Project; State of Ohio TECH 05–066, Atrial Fibrillation Innovation Center.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2006/11
Y1 - 2006/11
N2 - Background: Atrial fibrillation (AF) is a common complication after cardiac surgery and is associated with increased resource utilization. Recent evidence supports a role of inflammation in the development of AF. It is also known that red blood cell transfusion modulates inflammation by increasing plasma levels of inflammatory markers. Therefore, we tested the hypothesis that red blood cell transfusion increases the risk of postoperative AF for patients undergoing cardiac surgery. Methods: Between February 2002 and January 2005, 5,841 patients underwent isolated coronary artery bypass grafting with or without valve replacement. Patient and procedural variables associated with development of new-onset AF were identified by logistic regression. Propensity score matching was used to confirm results. Results: In addition to older age, prior history of AF, higher preoperative hematocrit, β-blocker withdrawal, longer aortic clamp time, valve surgery, and intensive care unit inotropic usage, intensive care unit red blood cell transfusion increased risk for AF (odds ratio per unit transfused, 1.18; 95% confidence limits, 1.14, 1.23; p < 0.0001). For the 1,360 propensity-matched pairs, intensive care unit red blood cell transfusion was associated with a significant increase in new-onset AF (620 [46%] versus 522 [38%]; p < 0.001). Conclusions: Intensive care unit red blood cell transfusion is associated with increased occurrence of postoperative AF after cardiac surgery. This factor should be considered in identifying patients who might benefit from prophylaxis to prevent this common postoperative complication.
AB - Background: Atrial fibrillation (AF) is a common complication after cardiac surgery and is associated with increased resource utilization. Recent evidence supports a role of inflammation in the development of AF. It is also known that red blood cell transfusion modulates inflammation by increasing plasma levels of inflammatory markers. Therefore, we tested the hypothesis that red blood cell transfusion increases the risk of postoperative AF for patients undergoing cardiac surgery. Methods: Between February 2002 and January 2005, 5,841 patients underwent isolated coronary artery bypass grafting with or without valve replacement. Patient and procedural variables associated with development of new-onset AF were identified by logistic regression. Propensity score matching was used to confirm results. Results: In addition to older age, prior history of AF, higher preoperative hematocrit, β-blocker withdrawal, longer aortic clamp time, valve surgery, and intensive care unit inotropic usage, intensive care unit red blood cell transfusion increased risk for AF (odds ratio per unit transfused, 1.18; 95% confidence limits, 1.14, 1.23; p < 0.0001). For the 1,360 propensity-matched pairs, intensive care unit red blood cell transfusion was associated with a significant increase in new-onset AF (620 [46%] versus 522 [38%]; p < 0.001). Conclusions: Intensive care unit red blood cell transfusion is associated with increased occurrence of postoperative AF after cardiac surgery. This factor should be considered in identifying patients who might benefit from prophylaxis to prevent this common postoperative complication.
UR - http://www.scopus.com/inward/record.url?scp=33750035357&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33750035357&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2006.05.045
DO - 10.1016/j.athoracsur.2006.05.045
M3 - Article
C2 - 17062241
AN - SCOPUS:33750035357
SN - 0003-4975
VL - 82
SP - 1747
EP - 1756
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -