Anemia, Cardiac Surgery, Mediation, Transfusion
Conditions
Brief summary
This study investigates the mediating role of intraoperative allogeneic red blood cell transfusion in the relationship between preoperative anaemia and postoperative complications in patients undergoing cardiac surgery. Using mediation analysis methods, we aim to determine whether and to what extent intraoperative transfusion explains the association between preoperative anaemia and adverse postoperative outcomes. By elucidating this pathway, the study seeks to inform perioperative blood management strategies and support more personalized, risk-adapted approaches to minimize postoperative complications in anaemic patients undergoing cardiac procedures.
Interventions
OTHERanemia
preoperative anemia
OTHERnonanemia
preoperative nonanemia
Sponsors
Second Affiliated Hospital, School of Medicine, Zhejiang University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 and older ； * Undergoing elective cardiac surgery with cardiopulmonary bypass
Exclusion criteria
* preoperative mechanical circulatory support * ASA physical status VI-V * unplanned intra-hospital reoperations * catheter-based valve replacements, * heart tumours, * stent implantation surgeries, * coronary angiography, * transvascular valve clamping, * tetralogy of Fallot, * ventricular aneurysms, * cardiomyopathies,
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Postoperative Complications | From the start of surgery to 30 days after surgery | The primary outcome is the occurrence of any postoperative complications during the index hospitalization. Complications include, but are not limited to, acute kidney injury (AKI), neurological complications, infections, and pulmonary complications. These are assessed using standardized diagnostic criteria. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Neurological Complications | From the start of surgery to 30 days after surgery | Occurrence of neurological complications such as postoperative delirium, stroke, or cognitive dysfunction, assessed based on clinical diagnosis and relevant neurocognitive evaluation. |
| Incidence of Infections | From the start of surgery to 30 days after surgery | Occurrence of postoperative infections including surgical site infection, bloodstream infection, and pneumonia, diagnosed according to CDC criteria. |
| Incidence of Acute Kidney Injury (AKI) | From the start of surgery to 30 days after surgery | Occurrence of AKI during postoperative hospitalization, defined according to the KDIGO (Kidney Disease: Improving Global Outcomes) criteria. |
| Length of Hospital Stay | From the start of surgery to 30 days after surgery | Duration of postoperative hospital stay, defined as the number of days from the date of surgery to the date of hospital discharge. |
| Total Hospitalization Cost | From the start of surgery to 30 days after surgery | Total direct medical cost incurred during the index hospitalization, including surgical costs, intensive care, ward care, medications, laboratory and imaging studies, and blood transfusion-related expenses. |
| Incidence of Pulmonary Complications | From the start of surgery to 30 days after surgery | Occurrence of pulmonary complications including pneumonia, pleural effusion, atelectasis, or need for prolonged mechanical ventilation (\>48 hours postoperatively). |
Countries
China
Outcome results
None listed