Is the disability of elderly patients related to increased blood transfusions after cardiac surgery?

Abstract

\n \n \n Type of funding sources: None.\n Intorduction. Perioperative bleeding occurs in 2 to 15% of patients. Cardiac surgeries are associated with perioperative blood loss due to the invasive nature of the procedures, the need for high doses of anticoagulation and the need for extracorporeal circulation. Both transfusions and reoperations due to excessive postoperative bleeding are associated with adverse clinical outcomes and increased costs of care. In 2017, the common position of the European Association of Cardiac Cancer Surgeons (EACTS) and the European Association of Cardiac Cancer Surgical Anesthesiologists (EACTA) regarding the management of patient blood in order to maintain adequate perioperative homeostasis and minimizing bleeding, and thus reducing the amount of blood transfusions. Advanced age is one of the factors associated with an increased risk of perioperative bleeding, including the need for transfusion and reoperation.\n Purpose. Assessment of the relationship between preoperative disability and the amount of blood transfused in elderly patients after cardiac surgeries.\n Methods. The study included 100 patients ≥ 65 years of age (40 women and 60 men, mean age M\u2009±\u2009SD =71.69\u2009±\u20094). A sociodemographic questionnaire and the Nagi scale for disability assessment were used to collect the research material. The Nagi scale assesses the limitations of the patient in seven activities. A significant disability is considered to be ≥ 3 points. The number of blood transfusions was assessed based on the analysis of medical records. The number of blood units transfused during hospitalization was taken into account. Statistically significant was assumed to be p\u2009<\u20090.05.\n Results. In the study group the mean score on the Nagi scale was M\u2009±\u2009SD = 3.41\u2009±\u20091.83 points. Blood transfusions were required by 66% of the study participants. The number of transfused blood units ranged from 1 to 11. The mean number of transfused blood units was 1.41\u2009±\u20091.83 points: M\u2009±\u2009SD = 1.56\u2009±\u20091.93. 28 patients required 1 blood unit, 11 blood units required 1 patient. There was a significant positive correlation between the values of the Nagi scale and the number of blood units transfused (r\u2009=\u20090.233, p\u2009=\u20090.019) . Moreover, the number of blood units transfused to patients with values of the Nagi scale ≥3 points turned out to be significantly higher than in patients with values of this scale <3 points (p\u2009=\u20090.015).\n Conclusions. 1) Patients with disability are qualified for cardiac surgeries. 2) Patients with disabilities require more blood units to be transfused.\n