Transfusions Risky For Cardiac Patients
Aug 8, 2009 - 1:45:23 PM
Blood transfusion to hospitalised cardiac patients doubles the risk of infection and quadruples the risk of death, according to a new study.
The analysis of nearly 25,000 'Medicare' patients in Michigan also showed that transfusion practices after heart surgery varied substantially among hospitals, a red flag that plays into the health care reform debate.
Blood transfusions are extremely common in the US. Some of the typical reasons for transfusions include prevention of anaemia and improving oxygen delivery in heart failure.
Blood transfusion is an area that could be well served with stronger, research-based guidelines, since the current clinical practice is all over the map, said study co-author Neil Blumberg, professor of pathology at the University of Rochester Medical Centre -.
'Doctors are simply doing what they were trained to do, but it turns out that their actions are more harmful than helpful in many cases,' Blumberg said.
'This is an instance in which clinical practice got way ahead of research. And changing the liberal use of transfusions is going to be difficult despite the evidence showing it is usually not essential.'
Blumberg and co-author Mary Rogers analysed patient records in 40 hospitals, from admission to 30 days after discharge.
All had received coronary artery bypass graft surgery from 2003 to 2006. They found that 30 percent of variation in transfusion practices seemed to be due to widely varied practices among hospital sites.
Also, blood use among women patients ranged from 72.5 percent to 100 percent, and blood use among men varied from about 50 percent to 100 percent.
Transfusions with donor blood were associated with infections of the genitourinary system, respiratory tract, bloodstream, digestive tract and skin, the study said.
The study was published in BMC Medicine.
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