A Meta-Analysis on the Outcomes of Blood transfusion in patients undergoing Transcatheter Aortic Valve Replacement (TAVR)
Tuesday, May 21, 2019
Belmont Ballroom 2-3 (The Cosmopolitan of Las Vegas)
Dinesh Reddy Apala
,
Creighton University, Omaha, NE
Aravdeep Jhand
,
Creighton University, OMAHA, NE
Abhishek Thandra
,
Creighton University, OMAHA, NE
Sai Giridhar Gundepalli
,
Creighton University, OMAHA, NE
Venkata M Alla
,
Creighton University, OMAHA, NE
Background:
Previously, studies have shown packed red blood cell (PRBC) transfusion peri-procedurally during TAVR is associated with poor outcomes. We conducted a meta-analysis to assess the above.
Methods:
PubMed, Cochrane and Web of Science databases were systematically searched. Outcomes of interest were mortality, length of stay (LOS), stroke and Acute kidney injury (AKI). The analysis was performed using DerSimonian and Laird random effect model.
Results:
Five studies met the inclusion criteria with a total of 2397 patient undergoing TAVR of which 819 patients received PRBC transfusion and 1578 did not receive any transfusion. There was no statistically significant difference in preoperative risk assessment between two groups as compared by log Euroscore (Std. mean difference: 0.36; 95% CI -0.12 to 0.84, p=0.14). When compared with patients who did not receive any RBC, patients who received RBC transfusion had significantly higher All cause 30day mortality(OR: 3.95; 95% CI: 1.6 to 9.6, p=0.0002), 1 year mortality, In-hospital mortality, ICU length of stay and Hospital length of stay (Std. mean difference: 1.67; 95% CI 1.1 to 2.2, p=0.000001). Also incidence of stroke and AKI was higher but no significant difference in incidence of MI. See the image attached for all Odds ratios with 95% CI.
Conclusions:
This meta-analysis shows, PRBC transfusion during TAVR is associated with poor outcomes which includes higher mortality rates, longer hospital LOS, stroke and AKI.
