Correlation Between Blood Transfusion and Postoperative Outcomes following Cardiac Surgery: A Systematic Review

  Objective  To systematically assess the correlation between blood transfusion and postoperative outcomes following cardiac surgery.

  Methods  Databases were searched for retrospective case-control studies on blood transfusion and postoperative outcome after cardiac surgery published in Chinese and English between January 1990 and December 2014. A meta-analysis was performed using RevMan 5.3 for quantitative synthesis of findings from included studies.

  Results  Thirteen retrospective case-control studies including 88 808 patients (42 991 blood transfusion cases, 45 817 non-transfusion cases) were eligible for inclusion. The pooled analysis revealed statistically significant differences in all the postoperative outcomes:30-day mortality (OR=2.39, 95% CI:1.71-3.34, P < 0.000 01), 1-year mortality (OR=3.08, 95% CI:2.18-4.35, P < 0.000 01), 5-year mortality (OR=1.90, 95% CI:1.42-2.56, P < 0.0001), ischemic accident (OR=2.23, 95% CI:1.71-2.90, P < 0.000 01), and infection (OR=2.18, 95% CI:1.74-2.75, P < 0.000 01).

  Conclusion  Perioperative blood transfusion may be strongly related with the risk of postoperative short- and long-term mortality, ischemic events, and infection following cardiac surgery.