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- Title
Fresh-frozen plasma transfusion did not reduce 30-day mortality in patients undergoing cardiopulmonary bypass cardiac surgery with excessive bleeding: the PLASMACARD multicenter cohort study.
- Authors
Doussau, Adélaïde; Perez, Paul; Puntous, Maryse; Calderon, Joachim; Jeanne, Michel; Germain, Christine; Rozec, Bertrand; Rondeau, Virginie; Chêne, Geneviève; Ouattara, Alexandre; Janvier, Gérard
- Abstract
Background During on-pump cardiac surgery, hemorrhagic complications occur frequently. Fresh-frozen plasma ( FFP) is widely transfused to provide coagulation factors. Yet, no randomized clinical trial has demonstrated its benefits on mortality. We assessed the relationship between therapeutic transfusion of FFP and 30-day mortality in cardiac surgery patients suffering from excessive bleeding in a prospective cohort study. Study Design and Methods Adult patients who underwent on-pump cardiac surgery and experienced excessive bleeding during the 48-hour perioperative period were recruited from 15 French centers between February 2004 and January 2006. Patients who received a preventive FFP transfusion were excluded. The association between FFP transfusion and all cause 30-day mortality was estimated using a Cox proportional hazards model, adjusted for confounding. A propensity score ( PS) sensitivity analysis was also performed. Results Among 967 patients included in this study, 58.1% received FFP. The median dose was 11.3 mL/kg (interquartile range, 7.6-19.5). The cumulative 30-day mortality rate was 11.3% (95% confidence interval [ CI], 9.5-13.5). FFP transfusion was associated with a higher 30-day mortality (hazard ratio [HR], 3.2; 95% CI, 1.7-6.1) in univariate analysis; however, after adjusting for prognostic factors, there was no longer any association ( HR, 1.5; 95% CI, 0.8-3.0, p = 0.20). The results of the PS analysis were consistent with the adjusted analysis. Conclusion Among on-pump cardiac surgery patients experiencing excessive perioperative bleeding, there is no evidence of a beneficial impact of FFP transfusion on mortality.
- Subjects
CARDIOPULMONARY bypass; BLOOD transfusion; BLOOD plasma; HEMORRHAGE complications; CARDIAC surgery; COHORT analysis; CLINICAL trials; BLOOD coagulation factors
- Publication
Transfusion, 2014, Vol 54, Issue 4, p1114
- ISSN
0041-1132
- Publication type
Article
- DOI
10.1111/trf.12422