U.S. Heart Patients May Get Too Many Blood Transfusions

Many of these potentially risky procedures may be unnecessary, researchers contend

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TUESDAY, Nov. 15, 2005 (HealthDay News) -- American heart patients receive more blood transfusions than heart patients in many other countries, which may indicate that U.S. doctors are too liberal in their use of transfusions, researchers say.

Researchers at Duke Clinical Research Institute in Durham, N.C., analyzed 24,000 patient records from 16 countries and found that transfusion rates for U.S. heart patients were 84 percent higher than in Europe, 72 percent higher than in Canada, 70 percent higher than in Australia, New Zealand and Latin America, and 38 percent higher than in Asia. South Africa was the only country with higher (10 percent more) transfusion rates than the United States.

The study was presented Tuesday at the American Heart Association's Scientific Sessions 2005 in Dallas.

The findings are important because previous research at Duke and other institutions has found that blood transfusions may not be as beneficial or benign as previously believed.

The Duke team cautioned doctors to carefully consider the need for transfusions and to factor in the ability of patients to increase blood counts without transfusions.

"The old dogma in medicine has been to treat aggressively, since you can always transfuse more blood but you can't replace heart muscle. In a setting like the U.S., where blood is a virtually unlimited resource, physicians are more apt to reflexively transfuse their patients," Duke cardiologist Dr. Sunil Rao said in a prepared statement.

"Blood transfusions are not like giving a patient an aspirin or Tylenol; they can be risky. Our message to physicians is to look at the whole patient and not just the blood count number, when considering whether or not to transfuse," Rao said.

"If patients appear to be fine, except for an abnormal blood number, it is probably best to hold off on transfusion. The body is constantly replenishing its blood supply, so in these patients it may be best to follow them to see if they can raise their blood counts on their own. If they don't, then the physician should investigate potential underlying causes why the patient's body isn't responding," Rao said.

More information

The American Medical Association has more about blood transfusion.

SOURCE: Duke University, news release, Nov. 15, 2005

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