Association of blood donor's biological characteristics on outcomes of cardiac surgery patients receiving red blood cells transfusion

Abstract

Objectives: This study aimed to assess the association of blood donor variables on the outcome of patients undergoing cardiac surgery.

Study design and methods: A retrospective observational study was conducted on patients who had cardiac surgery between January 2018 and December 2020. Blood donor characteristics such as age (≤ or >30 years), sex, and body mass index (BMI) (≤ or >25 kg/m²) were analyzed for association with patient outcomes (length of hospital stay (LOS), mortality, and readmission). Sex matching was done as fully match, fully mismatch, and partial mismatch. Cox regression and Linear regression models were used to study the association with mortality and readmission, and LOS.

Results: During the study period, 5788 patients had cardiac surgery; receiving a total of 20,348 red cell units. Of which, 522 (9%) died, 531 (9.2%) re-admitted and median LOS was 11 days (IQR 7-18). BMI >25 kg/m² (β, 2.96; p = 0.000), female to male transfusion (partial mismatch: β, 4.42; p = 0.001; fully mismatch: β, 9.0; p = 0.02) negatively affected LOS. BMI >25 kg/m² (HR, 2.07; p = 0.00) and partial mismatch transfusion to male patients (HR, 1.60; p = 0.01) increased mortality. Fully mismatch transfusion to female patients (HR, 1.24; p = 0.01) and partial mismatch to male patients (HR, 1.86; p = 0.01) increased readmission. No association of donor age on patient outcome was observed.

Discussion: Blood donor sex, and BMI can influence mortality and LOS in cardiac surgery patients. The use of computer tools to match the patient's and donor's characteristics can assist to eliminate these types of adverse consequences.

Keywords: Age; Donor characteristics; Mortality; Patient outcome; Sex.