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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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Risk prediction for transfusion of erythrocyte concentrate during extracorporeal circulation in coronary surgery
Session:
CO - Prémio Machado Macedo
Speaker:
p. Paiva
Congress:
CPC 2019
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
26.1 Cardiovascular Surgery – Coronary Arteries
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Patrícia Pinheiro Paiva
Abstract
<p>We have conducted a study of patients undergoing coronary artery bypass surgery (CABG) to identify preoperative risk factors and to develop and validate a risk prediction model for red blood cell (RBC) transfusion during extracorporeal circulation (ECC).</p> <p>This retrospective observational study includes consecutive patients who underwent on-pump isolated CABG, between January 2012 and December 2013. The risk model was developed and validated by logistic regression and bootstrap analysis. Discrimination and calibration were assessed using the area under the ROC curve (AUC) and the Hosmer - Lemeshow (H - L) test, respectively.</p> <p>Of the 530 patients included, RBC transfusion occurred in 91 (17.2%) during ECC. Of these, the majority was transfused with one (54.9%) or two (41.8%) packed RBC. The final model covariates (reported as odds ratios; 95% CIs) were age (1.07; 1.02-1.13), glomerular filtration rate (0.98; 0.96-1.00), body surface area (0.95; 0.92-0.98), peripheral vascular disease (3.03; 1.01-9.05), cerebrovascular disease (4.58; 1.29-16.18) and hematocrit (0.55; 0.48-0.63). The risk model developed has an excellent discriminatory power (AUC: 0,963). The results of the H-L test showed that the model predict accurately, both on average and across the ranges of patient deciles of risk.</p> <p>We have developed a risk prediction model for red blood cell transfusion during extracorporeal circulation which has performed adequately in terms of discrimination, calibration and stability over a wide spectrum of risk. Consequently, the risk model developed can be used as an instrument to provide accurate information about the risk RBC transfusion during ECC in our patient population. Additionally, could be used as a valuable adjunct for local improvement of clinical practice, particularly regarding treatment choice and resource allocation, informed consent and quality control.</p> <p><strong>Keywords: </strong>Blood transfusion; Red blood cell transfusion; Coronary artery bypass; Cardiopulmonary bypass; Risk factors; Risk stratification; Risk prediction model.</p>
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