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The Clinical Implication of Blood Product Transfusion on Morbidity and Mortality of Ruptured Abdominal Aortic Aneurysm.
Clin Appl Thromb Hemost. 2017 Sep; 23(6):601-606.CA

Abstract

BACKGROUND

Transfusion of blood products occurs frequently in ruptured abdominal aortic aneurysm surgery (rAAA). The aim of this study is to establish the impact of packed red blood cell (PRBC), fresh frozen plasma (FFP), and platelet (PLT) transfusion on the 30-day mortality and morbidity (thrombotic versus non thrombotic complications) of rAAAs.

METHODS

A retrospective study of 90 consecutive rAAAs from November 2007 to June 2015 was conducted. Multivariable regression models were produced to determine blood products associated with 30-day morbidity and mortality post-rAAA.

RESULTS

The overall mortality was 14.6%. At multivariable analyses, transfusion with FFP (>3 units) was independently associated with an increased risk of mortality (odds ratio [OR]: 11.27, 95% confidence interval [CI]: 1.13-96.72, P = .027). The overall morbidity was 26.8%, and subgroup analysis (thrombotic vs nonthrombotic complications) demonstrated transfusion of PLTs (>1 pool) to be independently associated with thrombotic events (OR: 4.3, 95% CI: 1.37-13.6, P = .012). Thrombotic events were responsible for 50% (n = 11 of 22) of all morbidities and mortalities (n = 6 of 12).

CONCLUSION

Transfusion of FFP and PLTs may be associated with an increased risk of postoperative morbidity and mortality. The use of these blood components should be considered in the context of the patient's clinical and laboratory data as opposed to a fixed ratio to PRBCs. This may result in the reduction in thrombotic complications emerging in rAAA cohort.

Authors+Show Affiliations

1 Department of Vascular & Endovascular Surgery, Broomfield Hospital, Mid Essex Hospitals Services NHS Trust, Essex, Broomfield, United Kingdom. 2 Anglia Ruskin University, Cambridge, United Kingdom.3 London North West Hospitals Trust, Imperial College London, London, United Kingdom.2 Anglia Ruskin University, Cambridge, United Kingdom.1 Department of Vascular & Endovascular Surgery, Broomfield Hospital, Mid Essex Hospitals Services NHS Trust, Essex, Broomfield, United Kingdom.1 Department of Vascular & Endovascular Surgery, Broomfield Hospital, Mid Essex Hospitals Services NHS Trust, Essex, Broomfield, United Kingdom.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26719355

Citation

Kordzadeh, Ali, et al. "The Clinical Implication of Blood Product Transfusion On Morbidity and Mortality of Ruptured Abdominal Aortic Aneurysm." Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, vol. 23, no. 6, 2017, pp. 601-606.
Kordzadeh A, Askari A, Parsa AD, et al. The Clinical Implication of Blood Product Transfusion on Morbidity and Mortality of Ruptured Abdominal Aortic Aneurysm. Clin Appl Thromb Hemost. 2017;23(6):601-606.
Kordzadeh, A., Askari, A., Parsa, A. D., Browne, T., & Panayiotopoulos, Y. P. (2017). The Clinical Implication of Blood Product Transfusion on Morbidity and Mortality of Ruptured Abdominal Aortic Aneurysm. Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 23(6), 601-606. https://doi.org/10.1177/1076029615624548
Kordzadeh A, et al. The Clinical Implication of Blood Product Transfusion On Morbidity and Mortality of Ruptured Abdominal Aortic Aneurysm. Clin Appl Thromb Hemost. 2017;23(6):601-606. PubMed PMID: 26719355.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Clinical Implication of Blood Product Transfusion on Morbidity and Mortality of Ruptured Abdominal Aortic Aneurysm. AU - Kordzadeh,Ali, AU - Askari,Alan, AU - Parsa,Ali D, AU - Browne,Tom, AU - Panayiotopoulos,Yiannis P, Y1 - 2015/12/29/ PY - 2016/1/1/pubmed PY - 2018/6/14/medline PY - 2016/1/1/entrez KW - blood component transfusion KW - blood transfusion KW - morbidity KW - mortality KW - platelet KW - ruptured abdominal aortic aneurysm (rAAA) KW - thrombosis: fresh frozen plasma SP - 601 EP - 606 JF - Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis JO - Clin Appl Thromb Hemost VL - 23 IS - 6 N2 - BACKGROUND: Transfusion of blood products occurs frequently in ruptured abdominal aortic aneurysm surgery (rAAA). The aim of this study is to establish the impact of packed red blood cell (PRBC), fresh frozen plasma (FFP), and platelet (PLT) transfusion on the 30-day mortality and morbidity (thrombotic versus non thrombotic complications) of rAAAs. METHODS: A retrospective study of 90 consecutive rAAAs from November 2007 to June 2015 was conducted. Multivariable regression models were produced to determine blood products associated with 30-day morbidity and mortality post-rAAA. RESULTS: The overall mortality was 14.6%. At multivariable analyses, transfusion with FFP (>3 units) was independently associated with an increased risk of mortality (odds ratio [OR]: 11.27, 95% confidence interval [CI]: 1.13-96.72, P = .027). The overall morbidity was 26.8%, and subgroup analysis (thrombotic vs nonthrombotic complications) demonstrated transfusion of PLTs (>1 pool) to be independently associated with thrombotic events (OR: 4.3, 95% CI: 1.37-13.6, P = .012). Thrombotic events were responsible for 50% (n = 11 of 22) of all morbidities and mortalities (n = 6 of 12). CONCLUSION: Transfusion of FFP and PLTs may be associated with an increased risk of postoperative morbidity and mortality. The use of these blood components should be considered in the context of the patient's clinical and laboratory data as opposed to a fixed ratio to PRBCs. This may result in the reduction in thrombotic complications emerging in rAAA cohort. SN - 1938-2723 UR - https://www.unboundmedicine.com/medline/citation/26719355/The_Clinical_Implication_of_Blood_Product_Transfusion_on_Morbidity_and_Mortality_of_Ruptured_Abdominal_Aortic_Aneurysm_ L2 - https://journals.sagepub.com/doi/10.1177/1076029615624548?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -