Postoperative Outcomes in Off-Pump Coronary Artery Bypass Grafting: A Comparative Study of Single Versus Multiple Transfusions

Abstract

Background: While blood transfusion is a common requirement during off-pump coronary artery bypass grafting (OPCAB), growing evidence points to a concerning association between higher transfusion volumes and poorer postoperative outcomes. Objective: Early postoperative complications were compared between OPCAB patients who received a single blood transfusion and those who required multiple transfusions. Materials and Method: This comparative cross-sectional study was conducted at Bangladesh Medical University, Dhaka, from July 2022 to June 2024. Sixty-eight patients undergoing OPCAB were enrolled and categorized into single transfusion (n=34) and multiple transfusion (n=34) groups. Using suitable statistical tests, baseline attributes, perioperative variables, and postoperative outcomes were thoroughly analyzed, with p≤0.05 set as the threshold for statistical significance. Results: No meaningful variances were observed between the two groups with respect to baseline demographic and clinical profiles. Patients receiving multiple transfusions required significantly higher blood volumes (3.15 ± 0.81 vs. 0.82 ± 0.20 units; p<0.001). The multiple transfusion group confirmed significantly higher rates of postoperative arrhythmia (33.33% vs. 12.12%; p=0.039), acute kidney injury (24.24% vs. 6.06%; p=0.039), coagulopathy (18.18% vs. 3.03%; p=0.045), and hypothermia (20.58% vs. 3.03%; p=0.045). Although infectious and pulmonary complications were more common, variances were not statistically significant. Conclusion: In patients undergoing OPCAB, exposure to multiple blood transfusions carries a significantly greater risk of postoperative morbidity, particularly arrhythmia, renal dysfunction, and coagulopathy. Optimizing perioperative blood management through restrictive transfusion strategies, as these findings suggest, could play a meaningful role in improving overall surgical outcomes.

J Med Coll Women Hosp.2026; 22(2): 168-176