{"id":30207,"date":"2012-07-02T16:08:41","date_gmt":"2012-07-02T20:08:41","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=30207"},"modified":"2012-07-02T16:08:41","modified_gmt":"2012-07-02T20:08:41","slug":"severe-blood-conservation-appears-safe-in-cardiac-surgery-for-jehovahs-witnesses","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/07\/02\/severe-blood-conservation-appears-safe-in-cardiac-surgery-for-jehovahs-witnesses\/","title":{"rendered":"Severe Blood Conservation Appears Safe in Cardiac Surgery for Jehovah&#8217;s Witnesses"},"content":{"rendered":"<p>Severe blood conservation in conjunction with cardiac surgery is not associated with long-term adverse consequences, according to a <a href=\"http:\/\/archinte.jamanetwork.com\/article.aspx?articleid=1211993\">new study<\/a> published in the <em>Archives of Internal Medicine<\/em>.<\/p>\n<p>Investigators from the Cleveland Clinic and the NHLBI compared 322 patients who were Jehovah&#8217;s Witnesses with an equal number of matched controls. Due to their religious beliefs, Witnesses do not receive blood transfusions, and therefore &#8220;provide a unique natural experiment in severe blood conservation,&#8221; according to the authors.<\/p>\n<p>Compared with patients who had transfusions, Witnesses had better short- and long-term\u00a0outcomes. They had fewer complications in the hospital and better survival out to 15 years.<\/p>\n<ul>\n<li>Perioperative MI: 0.31% for Witnesses vs. 2.8% for controls (p = 0.01)<\/li>\n<li>Operation for bleeding: 3.7% vs. 7.1% (p = 0.03)<\/li>\n<li>Prolonged ventilation: 6% vs. 16% (p &lt; 0.001)<\/li>\n<li>Hours in the ICU (15th, 50th, and 85th percentiles): 24 vs. 24, 25 vs. 48, and 72 vs. 162 (p &lt; 0.001)<\/li>\n<li>Survival at 5 years: 86% vs. 74%<\/li>\n<li>Survival at 10 years: 69% vs. 53%<\/li>\n<li>Survival at 15 years: 51% vs. 35%<\/li>\n<\/ul>\n<p>The investigators conclude that although they &#8220;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.&#8221;<\/p>\n<p>In an <a href=\"http:\/\/archinte.jamanetwork.com\/article.aspx?articleid=1211994\">accompanying commentary<\/a>,\u00a0 Victor Ferraris points out that &#8220;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.&#8221; Nevertheless, &#8220;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.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Severe blood conservation in conjunction with cardiac surgery is not associated with long-term adverse consequences, according to a new study published in the Archives of Internal Medicine. Investigators from the Cleveland Clinic and the NHLBI compared 322 patients who were Jehovah&#8217;s Witnesses with an equal number of matched controls. Due to their religious beliefs, Witnesses [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-30207","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/30207","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=30207"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/30207\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=30207"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=30207"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=30207"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}