Title : Comparison of autologous vs non-autologous blood transfusion in patients undergoing coronary artery bypass grafting surgery
Abstract:
Introduction: To compare autologous versus non-autologous transfusion in patients undergoing CABG and its early outcomes. This study seeks to evaluate the impact of different transfusion strategies on key postoperative outcomes, including morbidity and mortality.
Methodology: The observational study on retrospective data was conducted at Tertiary care hospital from January 2022 to December 2023. A total of 140 patients were included. Institutional review board approval was granted and inclusion criteria were met. For statistical analysis, Chi-square & T-test was used. Data was analyzed using SPSS 25. A P-value of <0.05 was considered statistically significant.
Results: In our study, we included 140 patients who underwent isolated CABG, divided equally into two groups: 70 in the autologous group and 70 in the non-autologous group. The autologous group comprised significantly younger patients compared to the homologous group (P 0.01). Additionally, the autologous group had a higher proportion of males, while the homologous group was predominantly female. Regarding co-morbidities, the autologous group had a significantly higher incidence of dyslipidemias (38.6%), whereas the homologous group had a greater prevalence of hypertension (90%). Pre-operatively, the mean hemoglobin levels were significantly higher in the autologous group (15.6±0.83) compared to the homologous group (P 0.001). However, there were no significant differences between the two groups in terms of intraoperative characteristics, including perfusion time, cross-clamp time, the number of IABP insertions, and intraoperative blood transfusions. In terms of outcomes, the homologous group demonstrated worse morbidity, characterized by a significantly higher requirement for post-operative blood transfusions (P 0.01) and prolonged mechanical ventilation hours (P 0.05). However, there were no notable differences between the two groups concerning ICU stay, re-exploration rates, re-intubation rates, or in-hospital mortality. Notably, the autologous group maintained significantly higher post-operative hemoglobin levels on the first, second, and discharge days compared to the homologous group (P 0.001).
Conclusion: Our study demonstrates that autologous transfusion is reasonable to do as it significantly reduces the morbidity by avoiding excessive blood transfusions and has better post-operative hemoglobin levels.
Keywords: Coronary Artery Bypass Grafting (CABG), autologous, homologous, blood transfusion, outcomes.
