Navigation Links
Less blood needed post-surgery, says NEJM study
Date:12/15/2011

NEW YORK -- Patients need less blood after surgery than is widely thought. A new study comparing two plans for giving blood transfusions following surgery showed no ill effects from postponing transfusion until patients develop signs of anemia or their hemoglobin concentration falls below 8 g/dL.

Results of the National Heart and Lung and Blood Institutefunded study are published in today's edition of the New England Journal of Medicine. NewYork-Presbyterian Hospital/Columbia University Medical Center is one of 47 centers participating in the FOCUS (Transfusion Trigger Trial for Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair) study, led by

Dr. Jeffrey Carson, Richard C. Reynolds Professor of Medicine at the UMDNJRobert Wood Johnson Medical School in New Brunswick, NJ.

Dr. William Macaulay, a co-author and member of the FOCUS steering committee, says, "This study will help resolve the debate about how much blood patients need after surgery. More often than not, a blood transfusion isn't necessary, even for elderly and sick patients.

"The implications are enormous. Reducing the number of blood transfusions will greatly decrease blood use, potentially saving an enormous amount of money," continues Dr. Macaulay, director of the Center for Hip and Knee Replacement at NewYork-Presbyterian Hospital/Columbia University Medical Center, chief of the Division of Adult Reconstructive Surgery of the Hip and Knee, and the Nas S. Eftekhar Professor of Clinical Orthopaedic Surgery at Columbia University College of Physicians and Surgeons.

In the United States, 14.6 million units of blood are transfused each year. Between 60 and 70 percent of blood transfusions are given to patients undergoing surgery and the majority of blood transfusions are given to older patients. Commonly, patients are given a transfusion if their hemoglobin level is at or below 10 g/dL, although a growing number of physicians follow a "restrictive" approach using a lower threshold or symptoms of anemia. In addition, some physicians choose to give blood transfusions to patients with higher blood counts if they are elderly or have cardiovascular disease. Normally, people have blood counts above 12 g/dL.

The study followed 2,016 patients aged 50 years or older with a history of or risk factors for cardiovascular disease, who underwent surgery for hip fracture. They were randomized into two groups: one that received a transfusion when their hemoglobin level fell below 10 g/dL (liberal group) and another that received a transfusion when they had symptoms of anemia, or at a physician's discretion if their hemoglobin was below 8 g/dL (restrictive group). The two groups had similar results for a large array of clinical outcomes, including risk for death within 60 days; functional recovery; risk for heart attack, infection, and falls; and symptoms such as fatigue. Median age was 82 years.

The difference in blood use was striking. Patients in the restrictive group received 65 percent fewer units of blood than the liberal group, and 58.5 percent of patients in the restrictive group did not receive any blood transfusion.

"As the medical community further embraces a restrictive approach to post-surgery blood transfusion, it's important that physicians carefully evaluate patients for symptoms of anemia, and not just rely on hemoglobin levels. The patient's body will often tell us when it needs blood," says Dr. Macaulay.

The FOCUS trial confirms findings of the 1999 Transfusion Requirements in Critical Care Investigators (TRICC) trial, which found that outcomes of a 7 g/dL transfusion threshold and a 10 g/dL threshold were similar for patients in an intensive care setting. FOCUS did not find evidence of increased rates of death, heart attack, or congestive heart failure in its liberal group, despite anecdotal evidence.


'/>"/>
Contact: Gloria Chin
glc9010@nyp.org
212-305-5587
New York- Presbyterian Hospital/Columbia University Medical Center
Source:Eurekalert

Related medicine news :

1. Team designs a bandage that spurs, guides blood vessel growth
2. Blood test might predict how well a depressed patient responds to antidepressants
3. Low Iron Levels May Increase Blood Clot Risk
4. Key genetic error found in family of blood cancers
5. University of Maryland finds restricting post-surgery blood transfusion is safe for some hip patients
6. Study Finds Fewer Blood Transfusions Needed After Hip Surgeries
7. Cancer Outpatients at Greater Risk for Blood Clots
8. Bone marrow and blood stem cell transplant survival rates equal, when donor is unrelated to patient
9. Massive DNA search uncovers new mutations driving blood cancer
10. Researchers use new finding to clear bloodstream malaria infection in mice
11. Blood pressure monitoring: Room for improvement
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... , ... June 25, 2016 , ... Austin residents seeking ... American College of Mohs Surgery and to Dr. Russell Peckham for medical and surgical ... effective treatment for skin cancer. The selective fellowship in Mohs Micrographic Surgery completed by ...
(Date:6/25/2016)... ... , ... "With 30 hand-drawn hand gesture animations, FCPX users can easily customize ... Pixel Film Studios. , ProHand Cartoon’s package transforms over 1,300 hand-drawn pictures into ... Simply select a ProHand generator and drag it above media or text in the ...
(Date:6/25/2016)... ... 25, 2016 , ... As a lifelong Southern Californian, Dr. Omkar Marathe earned ... the David Geffen School of Medicine at UCLA. He trained in Internal Medicine at ... fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he had the opportunity ...
(Date:6/25/2016)... ... 2016 , ... On Friday, June 10, Van Mitchell, Secretary of the Maryland ... iHire in recognition of their exemplary accomplishments in worksite health promotion. , The Wellness ... & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was one of ...
(Date:6/24/2016)... Los Angeles, CA (PRWEB) , ... June 24, 2016 , ... ... plastic surgery procedures that most people are unfamiliar with. The article goes on to ... known procedures, but also many of these less common operations such as calf and ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016   Bay Area ... Network,s Dean Center for Tick Borne Illness ... and Rehabilitation, MIT Hacking Medicine, University of California, ... today announced the five finalists of Lyme ... disease.  More than 100 scientists, clinicians, researchers, entrepreneurs, ...
(Date:6/24/2016)... Dehaier Medical Systems Ltd. (NASDAQ: DHRM ) ... medical devices and wearable sleep respiratory products in ... with Hongyuan Supply Chain Management Co., Ltd. (hereinafter referred ... to develop Dehaier,s new Internet medical technology business. ... Hongyuan Supply Chain,s sales platform to reach Dehaier,s dealers ...
(Date:6/24/2016)... LEXINGTON, Mass. , June 24, 2016   ... specialty pharmaceutical company developing innovative inhaled drugs, announced today ... when Russell Investments reconstituted its comprehensive set ... 2016. "This is an important milestone for ... "It will increase shareholder awareness of our progress in ...
Breaking Medicine Technology: