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Older blood associated with worse outcomes after repeat heart surgery

the in-hospital mortality rate for patients who received the "freshest" blood was about 4 percent, compared with a 25 percent rate for patients in the oldest blood group. In terms of kidney damage, the rate increased from about 7 percent in the freshest blood group to almost 45 percent in the oldest group.

Also, patients in the freshest blood group spent an average of 3.5 days in the intensive care unit, compared to about 7 days for those in the oldest blood group. In terms of overall hospital stay, patients in the freshest blood group had a 12-day stay, compared to 17 days for the oldest group.

Of the 295 patients who were ultimately discharged from the hospital, 16 percent died within the follow-up period of up to eight years. The researchers found that after statistically accounting for a number of different factors, both the average age of the blood received, as well as the oldest unit of blood received, were independent predictors of mortality.

The study was not designed to uncover the actual physiological mechanisms that cause the observed health problems, Bennett-Guerrero said. But previous studies have hinted at a number of possibilities, he said. It is known, for example, that transfused blood loses oxygen-carrying ability over time. Transfused blood also may stimulate an immune response in its recipient and red blood cells become stiffer over time, which could affect their ability to fit into or move through capillaries and deliver oxygen, he added.


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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
22-Jun-2006


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