July 4, 2012
JEHOVAH'S Witnesses, whose faith forbids them from blood transfusions, recover from heart surgery faster and with fewer complications than those who do get blood, in a study that may change thinking on current practice.
Patients who are Jehovah's Witnesses had better survival rates, shorter hospital stays, fewer additional operations for bleeding and spent fewer days in the intensive care unit than those who received blood transfusions during surgery, a study in the Archives of Internal Medicine shows.
Members of the Jehovah's Witness faith undergo extensive blood conservation before surgery, including red blood-cell boosting erythropoietin drugs, iron and B-complex vitamins to guard against anaemia. The practice offered a ''unique natural experiment'' for scientists to study the short and long-term effects of the blood management strategy and may point to ways to reduce need for transfusions, researchers said.
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''How we care for Jehovah's Witness patients with this pretty extreme blood conservation doesn't put a patient at increased risk,'' said Colleen Koch, a study author and professor of anaesthesiology at the Cleveland Clinic in Ohio. ''Perhaps it needs to be examined more closely applying some of these practices to our routine cardiac surgery patients.''
Researchers in the study included 322 Jehovah's Witness patients and 87,453 other patients who underwent heart surgery at the Cleveland Clinic from 1983 to 2011. All Jehovah's Witness patients refused blood transfusions. In the other group, 38,467 did not receive transfusions while 48,986 did.
The authors wanted to look at the difference between patients who receive blood transfusions during surgery and Jehovah's Witness patients, who undergo strict blood conservation practices before, during and after surgery, Koch said.
While many patients do not have blood transfusions during and after heart surgery, they also do not undergo the same blood conservation practices that doctors use for Jehovah's Witness patients, she said. The study found that Jehovah's Witnesses had lower occurrences of heart attack following surgery.
Jehovah's Witness patients had an 86 per cent chance of survival at five years and a 34 per cent chance of survival 20 years after surgery, compared with 74 per cent at five years and 23 per cent at 20 years for non-Jehovah's Witness patients who had transfusions.