No increased risk in patients who refuse transfusions after heart surgery

Source：JAMA Release Date：2012-07-05 366

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A study that examined outcomes of patients who refuse transfusion following cardiac surgery found they were at no increased risk for complications or death

CHICAGO – Jehovah’s Witness patients who undergo cardiac surgery do not appear to have a higher risk of developing surgical complications or dying when compared to patients who undergo cardiac surgery and receive blood transfusions. This is according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.

Jehovah’s Witness patients (Witnesses) hold beliefs that disallow transfusion of blood products and so encourage the use of a number of blood conservation practices.

The study sought to compare the morbidity and long-term survival rates of Witnesses undergoing cardiac surgery with a similarly matched group of patients who received blood transfusions. Witnesses (322 patients) and non-Witnesses (322 patients) were found to have had similar risks for hospital mortality, but Witnesses had significantly lower occurrence of additional operation for bleeding, renal failure, and sepsis.

Witnesses also had fewer acute complications, including myocardial infarction (heart attack), additional operations for bleeding and prolonged ventilation. Furthermore, Witnesses had shorter hospital lengths of stay compared with matched patients who received transfusions, as well as shorter intensive care unit lengths of stay.

Additionally, Witnesses had higher survival rates compared with non-Witnesses at one-year (95 per cent vs. 89 per cent). Both groups, however, had similar 20-year survival rates (34 per cent vs. 32 per cent).

“Although we found differences in complications among Witnesses and control groups that received transfusions, current extreme blood management strategies do not appear to place patients at heightened risk for reduced long-term survival,” the authors, headed by Gregory Pattakos, M.D., M.S., of the Cleveland Clinic, Ohio, conclude.

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