Featured Research

from universities, journals, and other organizations

Less blood needed post-surgery, new study suggests

Date:
January 12, 2012
Source:
New York- Presbyterian Hospital/Columbia University Medical Center
Summary:
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.

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.

Related Articles


Results of the National Heart and Lung and Blood Institute- funded study are published in a recent 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 UMDNJâ€"Robert 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.


Story Source:

The above story is based on materials provided by New York- Presbyterian Hospital/Columbia University Medical Center. Note: Materials may be edited for content and length.


Journal Reference:

  1. Jeffrey L. Carson, Michael L. Terrin, Helaine Noveck, David W. Sanders, Bernard R. Chaitman, George G. Rhoads, George Nemo, Karen Dragert, Lauren Beaupre, Kevin Hildebrand, William Macaulay, Courtland Lewis, Donald Richard Cook, Gwendolyn Dobbin, Khwaja J. Zakriya, Fred S. Apple, Rebecca A. Horney, Jay Magaziner. Liberal or Restrictive Transfusion in High-Risk Patients after Hip Surgery. New England Journal of Medicine, 2011; 365 (26): 2453 DOI: 10.1056/NEJMoa1012452

Cite This Page:

New York- Presbyterian Hospital/Columbia University Medical Center. "Less blood needed post-surgery, new study suggests." ScienceDaily. ScienceDaily, 12 January 2012. <www.sciencedaily.com/releases/2011/12/111215135844.htm>.
New York- Presbyterian Hospital/Columbia University Medical Center. (2012, January 12). Less blood needed post-surgery, new study suggests. ScienceDaily. Retrieved November 21, 2014 from www.sciencedaily.com/releases/2011/12/111215135844.htm
New York- Presbyterian Hospital/Columbia University Medical Center. "Less blood needed post-surgery, new study suggests." ScienceDaily. www.sciencedaily.com/releases/2011/12/111215135844.htm (accessed November 21, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, November 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

WFP: Ebola Risks Heightened Among Women Throughout Africa

WFP: Ebola Risks Heightened Among Women Throughout Africa

AFP (Nov. 21, 2014) — Having children has always been a frightening prospect in Sierra Leone, the world's most dangerous place to give birth, but Ebola has presented an alarming new threat for expectant mothers. Duration: 00:37 Video provided by AFP
Powered by NewsLook.com
Could Your Genes Be The Reason You're Single?

Could Your Genes Be The Reason You're Single?

Newsy (Nov. 21, 2014) — Researchers in Beijing discovered a gene called 5-HTA1, and carriers are reportedly 20 percent more likely to be single. Video provided by Newsy
Powered by NewsLook.com
Milestone Birthdays Can Bring Existential Crisis, Study Says

Milestone Birthdays Can Bring Existential Crisis, Study Says

Newsy (Nov. 21, 2014) — Researchers find that as people approach new decades in their lives they make bigger life decisions. Video provided by Newsy
Powered by NewsLook.com
Ebola: Life Without School in Guinea

Ebola: Life Without School in Guinea

AFP (Nov. 21, 2014) — Following the closure of schools and universities in Guinea because of the Ebola virus, students look for temporary work or gather in makeshift classrooms to catch up on their syllabus. Duration: 02:14 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins