Change in use of allogeneic red blood cell transfusions among surgical patients.

Journal of the American College of Surgeons
Julius Cuong PhamElliott R Haut

Abstract

Although RBC transfusions can be lifesaving, recent evidence suggests that their use is associated with added morbidity and mortality and that a lower transfusion threshold is safe. It is unclear if this new evidence has translated into decreased RBC use among surgical patients. The purpose of this study is to measure the change in use of RBCs during the last decade. We performed a cross-sectional cohort study of all patients who underwent inpatient operations in the 52 hospitals in Maryland in 1997 to 1998 and 2004 to 2005. The primary outcomes variable was whether or not the patient received an allogeneic RBC transfusion. We controlled for confounders related to RBC transfusion, including age, gender, race, type of admission, comorbid conditions, and surgeon patient-volume. Patients receiving RBCs were older (63 versus 52 years), were more likely to be admitted through the emergency department (37% versus 24%) or as a readmission (12% versus 6.9%), had more Romano-Charlson index comorbidities, and had a higher unadjusted mortality (6.5% versus 1.1%). Comparing 1997 to 1998 to 2004 to 2005, RBC use in surgical patients increased (8.9% versus 14%), although unadjusted mortality decreased (2.0% versus 1.5%). Factors associated w...Continue Reading

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Citations

Nov 6, 2013·The Journal of Surgical Research·Bala RamananRobert Armour Forse
Mar 15, 2012·Journal of Clinical Anesthesia·Carolyn Hyatt Sherman, Duncan C Macivor
Jun 18, 2010·Transfusion·Giora NetzerMichael L Terrin
Nov 3, 2010·Transfusion·Christine M Cserti-Gazdewich
Dec 3, 2013·JBJS Reviews·Atul F Kamath, Mark W Pagnano
Jul 22, 2011·The Journal of Bone and Joint Surgery. American Volume·Eva Y W TseKeith D K Luk
Aug 14, 2013·Critical Care Medicine·David J MurphySean M Berenholtz
Aug 22, 2013·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Michael D DallmanGiora Netzer
Sep 26, 2013·Critical Care Medicine·Babak Sarani
Sep 24, 2010·Journal of Perioperative Practice·Mukai Chimutengwende-GordonNimalan Maruthainar

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