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miércoles, 4 de julio de 2012

Effects Of Refusing Blood Transfusions After Cardiac Surgery/Efectos de rechazar las transfusiones de sangre después de cirugía cardiaca


The study, conducted by Gregory Pattakos, M.D., M.S., of the Cleveland Clinic, Ohio, and his team, is published in Archives of Internal Medicine.


The researchers enrolled 322 Jehovah Witness patients and 322 non-Witness patients in order to compare morbidity and long-term survival rates after cardiac surgery.


The researchers discovered that although the risk of dying was similar in both groups, Witnesses were considerably less likely than non-Witnesses who received transfusions to need additional surgery for bleeding. In addition, Witnesses were significantly less likely to have renal failure and sepsis, and were hospitalized for shorter durations than patients who received transfusions.


Witnesses also had fewer acute complications, including heart attack, and were less likely to require prolonged ventilation.


The team found that one-year survival rates after cardiac surgery were higher among Witnesses (95%) than non-Witnesses (89%). However, 20-year survival rates were comparable between the two groups, 34% vs. 32%, respectively.


The researchers conclude:


"Although we 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."



Victor A. Ferraris, M.D., Ph.D., of the University of Kentucky Chandler Medical Center, Lexington, explains in an invited commentary:


"Jehovah's Witnesses believe that the Bible prohibits ingesting blood and that Christians should therefore not accept blood transfusions or donate or store their own blood for transfusion.


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.


The findings of this analysis by Pattakos and colleagues add to the increasing data that suggest that more conservative use of blood transfusions would be in our patients' interest, in both Witnesses and non-Witnesses."

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