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Older Transfused Blood May Raise Heart Surgery Mortality

Worse outcomes after heart surgery when transfused red blood cells are older than 14 days

WEDNESDAY, March 19 (HealthDay News) -- Complication and mortality rates after heart surgery are higher when patients are transfused with red blood cells that have been stored for longer than 14 days, compared to more recently donated blood, researchers report in the March 20 issue of the New England Journal of Medicine.

Colleen Gorman Koch, M.D., of the Cleveland Clinic Foundation in Ohio, and colleagues studied the effect of duration of blood product storage on outcomes in patients who received red-cell transfusions during coronary-artery bypass grafting, heart-valve surgery, or both. The researchers analyzed data from 2,872 patients who received 8,802 units of "newer" blood (stored for 14 days or less), and 3,130 patients who received 10,782 units of "older" blood (stored for more than 14 days).

The investigators found that patients who received older blood had significantly increased rates of in-hospital mortality (2.8 percent versus 1.7 percent), prolonged intubation (9.7 percent versus 5.6 percent), renal failure (2.7 percent versus 1.6 percent), and sepsis or septicemia (4 percent versus 2.8 percent). In addition, one-year mortality was higher in patients receiving older blood (11 percent versus 7.4 percent).

"In patients undergoing cardiac surgery, transfusion of red cells that had been stored for more than two weeks was associated with a significantly increased risk of postoperative complications as well as reduced short-term and long-term survival."

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