Costs and outcomes after cardiac surgery in patients refusing transfusion compared with those who do not: a case-matched study.
Transfusion
; 55(12): 2791-8, 2015 Dec.
Article
em En
| MEDLINE
| ID: mdl-26183817
ABSTRACT
BACKGROUND:
Although numerous studies have demonstrated the feasibility of cardiac surgery for blood refusal patients, few studies match to controls, and fewer examine cost. This historical cohort study aims to compare costs and outcomes after cardiac surgery in Jehovah's Witness patients who refuse blood transfusion with a group of matched patients accepting transfusion. STUDY DESIGN ANDMETHODS:
A retrospective database review was performed to find all patients having cardiac surgery who refused blood products from January 2005 to July 2012 at Duke University Medical Center. These 45 patients were closely matched 12 with controls who accepted transfusion based on characteristics likely to influence transfusion. Cost from day of surgery to hospital discharge and other outcome data (length of stay [LOS], discharge hemoglobin [Hb], acute kidney injury) were analyzed retrospectively.RESULTS:
Forty-five Witnesses having cardiac surgery were temporally matched to two controls having the same surgery. Median euroSCORE was the same in both groups (6.0, p = 0.9981). In the matched-pairs comparison of cost, there was no significant difference in total cost for Witnesses and controls. There was no difference in intensive care unit LOS (median, 1 day, both groups) or total LOS (median, 9 days for Witnesses vs. 7 days for controls). Mean Hb at discharge was higher in Witnesses than in controls (11.7 g/dL vs. 9.8 g/dL, p < 0.001). Thirty-day mortality was zero in both groups.CONCLUSION:
Utilizing applicable blood conservation measures, cardiac surgery may be performed with similar outcomes and cost from day of surgery to discharge compared to controls in select patients without blood transfusion.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transfusão de Sangue
/
Custos de Cuidados de Saúde
/
Testemunhas de Jeová
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Procedimentos Cirúrgicos Cardíacos
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
Limite:
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
Transfusion
Ano de publicação:
2015
Tipo de documento:
Article