Variation Seen in Blood Transfusion Practices After PCI
Transfusion receipt linked to adverse cardiovascular events, regardless of bleeding complications
WEDNESDAY, Feb. 26, 2014 (HealthDay News) -- For patients undergoing percutaneous coronary intervention (PCI), blood transfusion rates and practices vary among hospitals, and transfusion receipt is associated with adverse coronary outcomes, according to a study published in the Feb. 26 issue of the Journal of the American Medical Association.
Matthew W. Sherwood, M.D., from the Duke Clinical Research Institute in Durham, N.C., and colleagues conducted a retrospective cohort study to determine current patterns of blood transfusion after PCI. Data were collected for 2,258,711 patient visits that included PCI at 1,431 hospitals from the CathPCI Registry from July 2009 to March 2013.
The researchers found that the overall transfusion rate was 2.14 percent. The quarterly transfusion rates decreased from July 2009 to March 2013 (2.11 to 2.04 percent; P < 0.001). Older patients, women, and patients with hypertension, diabetes, advanced renal dysfunction, and prior myocardial infarction or heart failure were more likely to receive transfusion. Overall, 3.7 percent of sites gave a transfusion to 5 percent of patients or more, while 96.3 percent gave a transfusion to less than 5 percent of patients. After adjustment, the variation in hospital risk-standardized transfusion rates persisted, and there was variability seen in hospital transfusion thresholds. Regardless of bleeding complications, transfusion receipt correlated with myocardial infarction (odds ratio [OR], 2.60), stroke (OR, 7.72), and in-hospital death (OR, 4.63).
"Among patients undergoing PCI at U.S. hospitals, there was considerable variation in blood transfusion practices, and receipt of transfusion was associated with increased risk of in-hospital adverse cardiac events," the authors write.
Two authors disclosed financial ties to the pharmaceutical and medical device industries.