Some Surgeons Still Believe Disproven Old Adage, “Blood Must Be Good”
Despite guidelines to restrict blood transfusions, a wide variation in practice persists across New York State, resulting in complications such as infections and pneumonia, a URMC study concluded.
The study, published in the Journal of GI Surgery, focused on transfusion data for patients who had surgery to remove cancer from the upper gastrointestinal tract, including the esophagus, pancreas and stomach. But previous studies have looked at transfusions in the context of heart and other surgeries, and arrived at similar conclusions: That giving a patient just a single unit of red blood cells during or after a surgery increases the risk of infection, wound-healing problems, pulmonary and kidney complications, sepsis, and is associated with higher rates of death.
Rochester investigators tried to determine how and why variations occur. Most other studies observed broad variability in transfusion rates among different hospitals, but the UR study found that 42 percent of the unexplained variation in blood transfusions stemmed from decisions made by individual surgeons.
“Because our study shows that variation rates may be related to surgeon practice patterns, it suggests that adherence to clinical-practice guidelines for surgeons is critical,” said Christopher T. Aquina, M.D., a general surgery resident and research fellow at the University of Rochester Medical Center, Surgical Health Outcomes & Research Enterprise (SHORE).
Better adherence to the protocols might also preserve the limited resources in blood banks and reduce the costs associated with giving blood transfusions, Aquina said.
Although blood transfusions can be life-saving in trauma cases and other complex medical situations, donor blood has been shown to suppress a patient’s immune system. URMC researchers have been leaders in advocating for fewer transfusions to reduce infections.
To read the full study, click here.
Leslie Orr |