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.
Study Type
OBSERVATIONAL
Enrollment
13,683
preoperative anemia
preoperative nonanemia
Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine
Hangzhou, Zhejiang, China
Incidence of Postoperative Complications
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.
Time frame: From the start of surgery to 30 days after surgery
Incidence of Acute Kidney Injury (AKI)
Occurrence of AKI during postoperative hospitalization, defined according to the KDIGO (Kidney Disease: Improving Global Outcomes) criteria.
Time frame: From the start of surgery to 30 days after surgery
Incidence of Neurological Complications
Occurrence of neurological complications such as postoperative delirium, stroke, or cognitive dysfunction, assessed based on clinical diagnosis and relevant neurocognitive evaluation.
Time frame: From the start of surgery to 30 days after surgery
Incidence of Infections
Occurrence of postoperative infections including surgical site infection, bloodstream infection, and pneumonia, diagnosed according to CDC criteria.
Time frame: From the start of surgery to 30 days after surgery
Incidence of Pulmonary Complications
Occurrence of pulmonary complications including pneumonia, pleural effusion, atelectasis, or need for prolonged mechanical ventilation (\>48 hours postoperatively).
Time frame: From the start of surgery to 30 days after surgery
Length of Hospital Stay
Duration of postoperative hospital stay, defined as the number of days from the date of surgery to the date of hospital discharge.
Time frame: From the start of surgery to 30 days after surgery
Total Hospitalization Cost
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.
Time frame: From the start of surgery to 30 days after surgery
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