Relationship between red blood cell transfusion and postoperative outcomes in patients undergoing coronary artery bypass grafting

This single-center retrospective observational cohort study with propensity score adjustment was conducted to investigate the association between perioperative red blood cell (RBC) transfusion and short-term outcomes in patients undergoing isolated coronary artery bypass grafting (CABG). Adult patients who underwent isolated CABG at our center between September 30, 2021 and February 29, 2024 were included. Patients were divided into two groups: those who received RBC transfusion (RBC+ group) and those who did not (RBC- group) perioperatively. Propensity score matching (PSM) was used to minimize the influence of potential confounding factors between groups. The clinical outcomes, including composite infectious complications, composite ischemic events, and in-hospital mortality, were compared between groups. Before PSM, 186 patients were included in the RBC+ group and 177 in the RBC− group. The RBC+ group had significantly higher rates of composite infectious complications, composite ischemic events, and in-hospital mortality than the RBC− group (all P < 0.001). After PSM (96 patients in each group), the RBC+ group still had significantly higher rates of composite infectious complications (P = 0.014) and composite ischemic events (P = 0.002) than the RBC− group; however, no statistically significant difference in in-hospital mortality was observed between the two groups (P = 0.155). In the RBC+ group, higher transfusion volumes were associated with a higher incidence of adverse clinical outcomes. Perioperative RBC transfusion was associated with a higher incidence of adverse postoperative clinical outcomes in patients undergoing isolated CABG.