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- Title
Five-year trends in perioperative red blood cell transfusion from index cases in five surgical specialties: 2011 to 2015.
- Authors
Mazzeffi, Michael A.; See, John M.; Williams, Brittney; Richards, Justin; Zimmerman, Darin; Galvagno, Samuel; Fontaine, Magali; Tanaka, Kenichi
- Abstract
<bold>Background: </bold>Red blood cell (RBC) transfusion can be life-saving; however, the risks of RBC transfusion have been increasingly recognized, and current guidelines recommend restrictive transfusion in most patients. We hypothesized that RBC transfusions are decreasing in surgical patients.<bold>Study Design and Methods: </bold>A retrospective review of the National Surgical Quality Improvement Program database was performed from 2011 to 2015. Index cases in five surgical specialties were studied: neurosurgery, thoracic surgery, gynecologic surgery, orthopedic surgery, and vascular surgery. Patient characteristics, preoperative laboratory values, and surgery details were compared between years. The study's primary outcome was perioperative RBC transfusion, which was compared over the 5-year period for each specialty. Secondary outcomes were myocardial infarction and renal failure after surgery. In addition, trends in RBC transfusion between low-risk and high-risk patients and between emergency and elective surgery were examined.<bold>Results: </bold>RBC transfusion decreased in all surgical specialties except for thoracic and gynecologic surgery. RBC transfusion decreased substantially in orthopedic surgery, falling from 22.4% in 2011 to 6.3% in 2015 (p ≤ 0.0001). High-risk patients had greater reductions in the receipt of RBC transfusion than low-risk patients, and there were no increases in myocardial infarction or renal failure after surgery in any specialty.<bold>Conclusion: </bold>RBC transfusion appears to be decreasing across multiple surgical specialties, with no apparent increase in myocardial infarctions or renal failure. This likely represents an important improvement in patient care. Continued efforts are needed to develop patient blood management programs and further reduce RBC transfusion.
- Subjects
RED blood cell transfusion; BLOOD transfusion; ERYTHROCYTES; MYOCARDIAL infarction; KIDNEY failure; KIDNEY diseases; MYOCARDIAL infarction risk factors; MEDICAL specialties &; specialists; ORTHOPEDIC surgery; QUALITY assurance; SURGERY practice; AT-risk people; RETROSPECTIVE studies; EVALUATION of human services programs; DESCRIPTIVE statistics; PERIOPERATIVE care; DISEASE risk factors
- Publication
Transfusion, 2018, Vol 58, Issue 5, p1271
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1111/trf.14559