Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Blood transfusion study: Less is more

A new study suggests that blood transfusions for hospitalized cardiac patients should be a last resort because they double the risk of infection and increase by four times the risk of death.

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.

A wide variation in care is a hot-button issue, as lawmakers and health reform experts discuss the best ways to address the variations. Some experts believe the country needs a system of medical guidelines, supported by scientific evidence, to aid doctors in decision-making. In fact, the Institute of Medicine has called for a national initiative of comparing the benefits and harms of certain methods to improve the delivery of care -- an effort referred to by health-care insiders as "comparative effectiveness" research.

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, M.D., professor of Pathology and Laboratory Medicine and director of Transfusion Medicine at the University of Rochester Medical Center.

"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."

The study was published July 31, 2009 in the journal, BMC Medicine. It was designed to assess patient outcomes as well as hospital variation in blood use.

Blumberg and lead author Mary Rogers, Ph.D., of the University of Michigan Health System, analyzed 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 risk of death in the hospital was nearly 5 times greater among patients who received a blood transfusion, and the risk of death in the next 30 days was nearly three times greater. Some of the risk may've been due to the underlying condition that led to transfusion but an increasingly convincing body of evidence demonstrates that some of the effect is almost certainly due to the transfusion itself, Blumberg said.

Blood transfusions are extremely common in the United States. Some of the typical reasons for transfusions include prevention of anemia and improving oxygen delivery in heart failure.

Blumberg has been a long-time advocate for fewer transfusions and, when they are necessary, for using blood from which the donor's white cells have been removed. This process, called leukoreduction, is believed to diminish the chances of infection and inflammation, research has shown.

"Blood transfusions are certainly necessary in life-threatening situations," Blumberg said. "But this study and other studies confirm they should be a last resort, not a first resort, as they often are."

For decades the URMC has been a leader in the study of blood transfusions, and Strong Memorial Hospital at URMC was among the first in the country to begin using leukoreduced blood for all its patients.

More recently, a team at Strong began to further refine the guidelines for blood transfusion. As a result the hospital has already seen a 10 to 15 percent drop in transfusions during the past six months. The improvement program is still in its early stages, and Blumberg said they will closely monitor the use of transfusions at Strong in the coming months.

Karin Christensen | EurekAlert!
Further information:

More articles from Studies and Analyses:

nachricht Diagnoses: When Are Several Opinions Better Than One?
19.07.2016 | Max-Planck-Institut für Bildungsforschung

nachricht High in calories and low in nutrients when adolescents share pictures of food online
07.04.2016 | University of Gothenburg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Etching Microstructures with Lasers

Ultrafast lasers have introduced new possibilities in engraving ultrafine structures, and scientists are now also investigating how to use them to etch microstructures into thin glass. There are possible applications in analytics (lab on a chip) and especially in electronics and the consumer sector, where great interest has been shown.

This new method was born of a surprising phenomenon: irradiating glass in a particular way with an ultrafast laser has the effect of making the glass up to a...

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Greater Range and Longer Lifetime

26.10.2016 | Power and Electrical Engineering

VDI presents International Bionic Award of the Schauenburg Foundation

26.10.2016 | Awards Funding

3-D-printed magnets

26.10.2016 | Power and Electrical Engineering

More VideoLinks >>>