Objectives
The association of cryoprecipitate transfusion with patient outcomes after cardiac
surgery is unclear. We aimed to investigate the predictors of, and outcomes associated
with, postoperative cryoprecipitate transfusion in cardiac surgery patients.
Methods
We used the Medical Information Mart for Intensive Care III and IV databases. We included
adults undergoing cardiac surgery, and propensity score matched cryoprecipitate-treated
patients to controls. Using the matched cohort, we investigated the association of
cryoprecipitate use with clinical outcomes. The primary outcome was in-hospital mortality.
Secondary outcomes were infection, acute kidney injury, intensive care unit length
of stay, hospital length of stay, and chest tube output at 2-hour intervals.
Results
Of 12,043 eligible patients, 283 (2.35%) patients received cryoprecipitate. The median
dose was 5.83 units (IQR 4.17–7.24) given at a median first transfusion time of 1.75
hours (IQR 0.73–4.46) after intensive care unit admission. After propensity scoring,
we matched 195 cryoprecipitate recipients to 743 controls. Postoperative cryoprecipitate
transfusion was not significantly associated with in-hospital mortality (odds ratio
[OR] 1.10; 99% confidence interval [CI] 0.43–2.84; p=0.791), infection (OR 0.77; 99%
CI 0.45–1.34; p=0.220), acute kidney injury (OR 1.03; 99% CI 0.65–1.62; p=0.876) or
cumulative chest tube output (adjusted mean difference 8 hrs post transfusion, 11
mL; 99% CI -104 to 125; p=0.804).
Conclusions
Although cryoprecipitate was typically given to sicker patients with more bleeding,
its administration was not associated with worse outcomes. Large, multicentred studies
are warranted to further elucidate cryoprecipitate’s safety profile and patterns of
use in cardiac surgery.
Keywords
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Article info
Publication history
Published online: December 16, 2022
Accepted:
November 16,
2022
Received in revised form:
November 14,
2022
Received:
September 12,
2022
Identification
Copyright
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
