Introduction: Blood transfusions are often necessary to control bleeding and maintain hemodynamic stability during cardiac surgery. However, using blood products may be associated with poor postoperative outcomes, such as arrhythmias, gastrointestinal bleeding, prolonged ventilation, and higher mortality. This study aimed to investigate the correlation between the intraoperative administration of specific blood products and 30-day postoperative mortality in adult patients undergoing cardiac surgery. Methods: We conducted a retrospective analysis of patients from our institutional Society of Thoracic Surgeons Adult Cardiac Surgery Database. We included adults undergoing cardiac surgery. To isolate the effect of intraoperative transfusion, patients who received postoperative blood products were excluded. The primary outcome was 30-day mortality. Univariate comparisons assessed differences in complication rates between intraoperative transfusions and those who did not. A multivariable logistic regression model within the transfused cohort evaluated the association between 30-day mortality and the type and quantity of intraoperative blood products administered. Results: A total of 503 patients met the inclusion criteria, 93 (18.5%) had intraoperative transfusion. The 30-day mortality rates were markedly elevated in transfused patients relative to non-transfused individuals (8.6% vs. 0.2%, p < 0.001). Increased red blood cell (RBC) transfusion volumes were found to be independently linked to higher 30-day mortality risks within the transfused group (odds ratio 5.44, 95% CI 1.94–24.65, p = 0.009), according to multivariable analysis. No significant associations were observed between mortality and intraoperative administration of FFP, platelets, or cryoprecipitate. Conclusions: Intraoperative RBC transfusion was significantly correlated with an elevated risk of mortality within 30 days post-cardiac surgery. These results support the cautious use of blood products during cardiac surgery, although transfusion probably reflects the severity of the illness and the complexity of the procedure. More prospective research is needed to determine causality and guide transfusion practices in this high-risk population.
Akben et al. (Sun,) studied this question.