Posts Tagged ‘cardiac surgery’

Transfusion in cardiac surgery – a crap shoot that doesn’t affect outcome?

Wednesday, October 13th, 2010

Two articles in JAMA document that:

  • Transfusion practices vary tremendously amongst institutions…
    • “Results At hospitals performing at least 100 on-pump CABG operations (82 446 cases at 408 sites), the rates of blood transfusion ranged from 7.8% to 92.8% for RBCs, 0% to 97.5% for fresh-frozen plasma, and 0.4% to 90.4% for platelets. Multivariable analysis including data from all 798 sites (102470 cases) revealed that after adjustment for patient-level risk factors, hospital transfusion rates varied by geographic location (P = .007), academic status (P = .03), and hospital volume (P < .001). However, these 3 hospital characteristics combined only explained 11.1% of the variation in hospital risk-adjusted RBC usage. Case mix explained 20.1% of the variation between hospitals in RBC usage.”
  • After cardiac surgery, a restrictive transfusion strategy (Hgb 9.1) appears to result in equivalent outcomes compared to a liberal one (Hgb 10.5)….
    • “The TRACS Randomized Controlled Trial… Conclusion Among patients undergoing cardiac surgery, the use of a restrictive perioperative transfusion strategy compared with a more liberal strategy resulted in noninferior rates of the combined outcome of 30-day all-cause mortality and severe morbidity.”