Severe Blood Conservation Appears Safe In Cardiac Surgery For Jehovah's Witnesses

[rbrown1205]

http://www.forbes.com/sites/larryhusten/2012/07/02/severe-blood-conservation-appears-safe-in-cardiac-surgery-for-jehovahs-witnesses/

Larry Husten, Contributor

Pharma & Healthcare

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7/02/2012 @ 4:12PM |170 views

Severe Blood Conservation Appears Safe In Cardiac Surgery For Jehovah's Witnesses

Severe blood conservation in conjunction with cardiac surgery is not associated with long-term adverse consequences, according to a new study published in Archives of Internal Medicine. 

Investigators from the Cleveland Clinic and the NHLBI compared 322 patients who were Jehovan’s Witnesses with an equal number of matched controls. Due to their religious beliefs Witnesses do not receive blood transfusions, and therefore “provide a unique natural experiment in severe blood conservation,” according to the authors.

Compared to patients who had transfusions, Witnesses had better short term and long term outcomes. They had fewer complications in the hospital and better survival out to 15 years.

Perioperative MI: 0.31% for Witnesses versus vs 2.8% for controls (p = .01)

Operation for bleeding: 3.7% vs 7.1% (p = .03)

Prolonged ventilation: 6% vs 16% (p < .001)

Hours in the ICU (15th, 50th, and 85th percentiles): 24 versus 24, 25 versus 48, and 72 versus 162 (p < .001)

Survival at 5 years: 86% versus 74%

Survival at 10 years: 69% versus 53%

Survival at 15 years: 51% versus 35%

The investigators concluded that although they “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.”

In an accompanying editorial, Victor Ferraris points out that “Witnesses who undergo cardiac surgery are likely a healthier subgroup of Witnesses because those who are believed by their surgeons to require blood transfusion to survive cardiac surgery presumably never go to the operating room.” Nevertheless, “the finding that the Witnesses who did not receive transfusions did at least as well as, if not better than, those who received a transfusion raises questions about whether more patients might benefit from surgical strategies that minimize transfusion of blood products.”

[pnutts]

There is another study-much larger ( thousands )-found same results. Don't have study details in front of me-have 6 dozen or so videos ( some 8 hours long-most 30 minutes or less ) plus hundreds ( maybe ) of articles. Many can be found at noblood.org or Network for Advancement of Transfusion Alternatives -not a witness site. Plus there is SABM- now out of Englewood hospital - which made a huge difference in its outlook and quality.