Impact of surgeon experience on the rate of blood transfusion in off-pump coronary artery bypass
Journal
Journal of the Formosan Medical Association = Taiwan yi zhi
Journal Volume
115
Journal Issue
3
Date Issued
2016-03
Author(s)
Abstract
Background/purpose: Off-pump coronary artery bypass (OPCAB) reduces the rate of blood transfusion. No studies have focused on the effect of surgeon experience on the transfusion rate. We sought to assess the transfusion rate in OPCAB and to evaluate the effect of surgeon experience.
Methods: Retrospective review of 1055 consecutive patients undergoing OPCAB between 2000 and 2012. Patients were divided into tripartites by the year of operation (2000-2004, 2005-2008, and 2009-2012). Surgeon experience was evaluated with revascularization index and conversion rate.
Results: Mode of intervention was elective in 768, urgency in 185, and emergency in 102 patients (10%). Blood transfusion was associated with increased rates of hospital mortality and sternal wound/bloodstream infections. Revascularization index was 1.22 ± 0.29 per patient and increased over time, from 1.05 ± 0.21 in 2000-2004 to 1.39 ± 0.26 in 2009-2012. Conversion rate was 10% and decreased over time, from 17% in 2000-2004 to 6% in 2009-2012. The average rate of blood transfusion was 58% and decreased over time, from 74% in 2000-2004 to 41% in 2009-2012. Rate of red blood cell transfusion was 56% and decreased from 72% in 2000-2004 to 40% in 2009-2012. Rate of platelet transfusion was 21% and decreased from 25% in 2000-2004 to 15% in 2009-2012.The most significant decrease in the transfusion rate was observed in nonemergency cases.
Conclusion: Surgeon experience reduced the need of blood transfusion after OPCAB. Increasing surgeon experience was associated with a 33% reduction in blood transfusion rate.
Subjects
blood transfusion
off-pump coronary artery bypass
surgeon experience
SDGs
Other Subjects
adult; aged; Article; blood transfusion; bloodstream infection; cardiac surgeon; cardiovascular mortality; cohort analysis; controlled study; elective surgery; emergency surgery; erythrocyte transfusion; female; human; major clinical study; male; observational study; off pump coronary surgery; operative blood loss; perioperative period; retrospective study; sternal wound infection; surgical infection; surgical mortality; thrombocyte transfusion; work experience; blood transfusion; hospital mortality; middle aged; multivariate analysis; professional competence; standards; statistical model; statistics and numerical data; surgeon; Taiwan; very elderly; Adult; Aged; Aged, 80 and over; Blood Transfusion; Coronary Artery Bypass, Off-Pump; Female; Hospital Mortality; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Professional Competence; Retrospective Studies; Surgeons; Taiwan
Publisher
Elsevier B.V.
Type
journal article