Peri-Operative Anemia and Blood Transfusion in Patients Undergoing Primary CABG Surgery: A Retrospective Study

Background: Pre-operative anemia is prevalent among patients undergoing coronary artery bypass grafting (CABG) and poses significant risks due to its impact on oxygen transport and surgical outcomes. This study investigates the incidence of pre-operative anemia in CABG patients and its association with peri-operative blood product transfusions. Methods: A retrospective review was conducted at Cleveland Clinic Abu Dhabi, analyzing medical records of 100 patients who underwent primary CABG from December 2023 to May 2024. Pre-operative hemoglobin levels were assessed, and anemia was classified per WHO criteria. We documented treatment strategies, intra-operative and post-operative blood product transfusions, and performed multivariate regression analysis to evaluate the impact of pre-operative anemia on post-operative hemoglobin levels. Results: The cohort comprised predominantly male patients (9:1 ratio), with 36% presenting with pre-operative anemia. Despite its prevalence, only 5.5% received pre-operative treatment. Post-operatively, 91% of patients remained anemic, increasing to 97% by discharge. Anemic patients had higher transfusion rates, with 36% receiving intra-operative packed red blood cells (PRBCs) compared to 6% of non-anemic patients. This trend continued post-operatively (44% vs. 19%). Non-PRBC blood product usage was also higher in non-anemic patients during surgery. Conclusion: The findings highlight a critical need for improved screening and management of pre-operative anemia in CABG patients. Addressing this issue could enhance patient outcomes and reduce transfusion-related complications. Implementing standardized anemia management protocols in pre-operative care pathways is essential for optimizing surgical results and resource utilization. Further research across multiple centers is warranted to validate these findings and enhance clinical practices.