Temporal Trends and Risk Factors Associated With Blood Transfusion in Patients Receiving Intra-Aortic Balloon Pump Support: A National Inpatient Sample Study (2010-2019).

BACKGROUND

Despite the widespread use of intra-aortic balloon pump (IABP) support in contemporary cardiac care, the factors influencing transfusion practices remain insufficiently understood.

METHODS

This study analyzed IABP placement data from the Nationwide Inpatient Sample database from 2010 to 2019. Multivariable logistic regression was used to identify factors associated with transfusion. The analysis included demographic factors, institutional characteristics, medical conditions, and procedural complications.

RESULTS

In a nationwide analysis of 93,014 IABP insertions, 20.9% required blood transfusion, with rates declining from 23.2% (2010) to 17.9% (2019). Significant factors associated with transfusion included: advanced age (≥65 years), female, medical condition ≥1, race (Black, Hispanic, and Asian/Pacific Islander), medium/large hospitals, urban hospitals, and hospitals in the West. Medical conditions associated with increased transfusion likelihood included deficiency anemia, chronic blood loss anemia, coagulopathy, rheumatoid arthritis/collagen vascular diseases, diabetes, hypothyroidism, hypertension, peripheral vascular disorders, renal failure, chronic pulmonary disease, fluid and electrolyte disorders, paralysis, and vascular disease. Blood transfusion was associated with more complications, longer hospital stays (median 11 days vs. 7 days), and costlier total charges (median $243,153 vs. $157,301) ( P < 0.001). Despite this, transfused patients had slightly better survival rates during hospitalization (19.1% vs. 20.4% mortality, P < 0.001).

CONCLUSION

Transfusion rates in IABP recipients declined yet remain clinically consequential, with relevant factors including age, medical conditions, and complications. These findings warrant prospective validation.