ArticleCureus2025
Impact of Low Hematocrit on On-Pump Coronary Artery Bypass Graft Surgery Outcomes.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Hematocrit and 28-day mortality in mechanically ventilated septic patients: a prospective observational study.Frontiers in medicine · 2026Article
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10 authors.
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Abstract
backgroundLow hematocrit level is a hematological problem that is frequently encountered during cardiopulmonary bypass (CPB) in patients undergoing on-pump coronary artery bypass grafting (CABG). This study aimed to assess the impact of low hematocrit levels (≤22%) during CPB on the adverse outcomes of on-pump CABG in a large-scale, age- and sex-adjusted Bangladeshi population. MATERIALS AND
methodsThis comparative cross-sectional study recruited 350 patients, age- and sex-matched, and divided them into two groups: Group A, comprising 175 patients with a hematocrit level of ≤22% on CPB, and Group B, comprising 175 patients with a hematocrit level of >22% on CPB. Univariate analysis curtailed the risk patterns, whereas multivariate logistic regression (LR) analysis observed independent predictors of postoperative adverse outcomes.
resultsThe mean age was similar between Group A and Group B (57.82 ± 6.32 vs. 56.97 ± 6.49 years, P = 0.57), with a male predominance in both groups (135 (77.1%) vs. 130 (74.3%), χ² = 0.24, P = 0.78). Univariate analysis showed that Group A had longer mechanical ventilation hours (15.09 ± 2.64 vs. 12.57 ± 3.90, P = 0.002), required more blood transfusions (3.67 ± 1.48 vs. 1.94 ± 0.79 units, P = 0.001), and had longer ICU stays (5.05 ± 0.96 vs. 3.45 ± 1.12 days, P = 0.001) compared with Group B. Postoperative complications were also more frequent in Group A, including acute kidney injury (AKI) (34.3% vs. 14.3%, χ² = 17.96, P < 0.001), deep sternal infection (8.6% vs. 2.9%, χ² = 4.29, P = 0.03), and in-hospital mortality (5.7% vs. 2.9%, χ² = 1.11, P = 0.02). In age- and sex-adjusted multivariate LR analysis, a hematocrit level ≤22% during CPB was significantly associated with adverse outcomes: higher blood transfusion requirements (odds ratio (OR) = 5.95, 95% CI 1.21-9.83, P = 0.001), longer ICU stays (OR = 3.27, 95% CI 1.06-4.24, P = 0.02), AKI (OR = 3.13, 95% CI 1.19-8.14, P = 0.01), deep sternal infection (OR = 1.18, 95% CI 1.31-6.24, P = 0.04), and in-hospital mortality (OR = 1.56, 95% CI 1.17-7.28, P = 0.03). A receiver operating characteristic (ROC) curve analysis yielded an area under the ROC curve of 0.756 (95% CI 0.65-0.86; P < 0.001) for predicting adverse outcomes, with 80.0% sensitivity and 45.0% specificity at a 22% hematocrit threshold.
conclusionsHematocrit levels of 22% or lower during CPB are associated with increased morbidity and mortality following on-pump CABG. Maintaining hematocrit levels above 22% during CPB is therefore recommended to improve postoperative outcomes.
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