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Science Forum Index » Medicine - Nursing Forum » Transfusions / five times more likely to die
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| ironjustice |
 Posted: Tue Dec 19, 2006 8:30 pm |
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Public release date: 19-Dec-2006
Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
Blood transfusions raise heart patients' infection and death risk --
especially women
New finding helps 'connect the dots' of a women-specific medical
mystery
ANN ARBOR, Mich. -- Blood transfusions save the lives of millions of
heart surgery patients and others each year. But a new study suggests
that patients who receive transfusions during heart bypass surgery have
a higher risk of developing potentially dangerous infections, and
dying, after their operation.
In fact, this increased risk may help explain a longstanding medical
mystery: why women bypass patients are more likely than men to die in
the first few months after surgery. Women are more likely to receive
blood during heart bypass operations, which are performed on more than
465,000 Americans each year.
The findings, from the Patient Safety Enhancement Program (PSEP) at the
University of Michigan Health System, are based on data from 9,218
Michigan bypass patients. After adjusting for factors such as the
urgency of the operation, those who received blood transfusions from
donors were five times more likely to die within 100 days of their
operation than those who did not.
The paper is published in the December issue of the American Heart
Journal. It builds on a previous U-M analysis that found that a
difference in infection rates accounted for the difference in death
risk between men and women bypass patients.
The U-M team, with the help of Neil Blumberg, M.D., of the University
of Rochester Medical Center, focused on blood transfusions as a
contributing factor. Prior research has shown that recipients of stored
donor blood have more post-surgical infections, and that women receive
more transfusions because they tend to have lower hemoglobin
concentrations.
This new study connects the dots. "To the best of our knowledge, this
is the first study to state that allogeneic transfusions may be the
reason why women have a greater post-bypass surgery mortality risk than
men," says author Mary A.M. Rogers, Ph.D., M.S., PSEP, research
director and research assistant professor of internal medicine.
Allogeneic is the term for blood from another person.
The authors strongly note that blood transfusions can be life-saving,
and that the infections observed in this study are not likely due to
contamination of the blood. Rather, they may be due to other factors,
including the patient's immune response to substances such as white
blood cells that are present in stored donor blood. These findings may
help guide hospitals and blood banks in deciding whether to filter
donated blood to reduce the levels of white blood cells. This practice
is increasingly common, but not yet universal, in the United States.
The study is based on analysis of data from all Medicare beneficiaries
ages 65 and older who had coronary artery bypass operations in Michigan
in a single year.
The researchers performed statistical analyses that took into account
the patients' blood transfusion status, their co-existing diseases,
age, race, sex, and whether the bypass operation was done on an
elective, urgent or emergency basis. They looked at infections and
deaths that were reported during the 100 days after surgery.
In all, about 88 percent of women received an allogeneic blood
transfusion during bypass surgery, compared with nearly 67 percent of
men. When the researchers adjusted for other factors, women were 3.4
times as likely as men to receive blood. This gender difference was
evident regardless of whether the operation was elective, urgent or
emergency.
The odds of having an infection of any kind were about three times
greater in patients who received allogeneic blood than in patients who
did not. The more blood they received, the higher their infection risk.
This "dose dependent" relationship strengthens the evidence that
transfusions may be related to infections.
No single type of infection stood out as more common among blood
recipients, which suggests a body-wide immune response issue rather
than a problem, for example, at the site of the incision.
The analyses revealed that women were more likely to experience an
infection than men after bypass surgery, which appeared to be due to
the increased number of transfusions in women. This resulted in an
increased mortality rate in women. Overall, 9 percent of women and 6
percent of the men died within 100 days of their operation.
For patients who had banked their own blood ahead of the operation and
who received only their own blood, the infection risk was similar to
that of patients who received no blood transfusions. Rogers notes that
patients should ask their doctors regarding banking their own blood if
possible, when scheduled for a bypass operation or other kind of
surgery.
In addition, physicians are increasing their use of transfusion
alternatives such as blood "expanders," blood substitutes and
blood-conserving procedures during bypass surgeries.
The results also highlight the importance of the proper use of
antibiotics and infection control practices in patients hospitalized
for a surgical procedure, says Rogers.
The U-M team is investigating the issue further, including a new study
funded by Blue Cross Blue Shield of Michigan Foundation to extend the
research into elderly patients who recently underwent bypass surgeries
in Michigan.
###
In addition to Rogers and Blumberg, the study authors included PSEP
director Sanjay Saint, M.D., MPH; Catherine Kim, M.D., MPH; Brahmajee
Nallamothu, M.D., MPH; and Kenneth Langa, M.D., Ph.D. It was funded by
the Agency for Healthcare Research and Quality, the National Institutes
of Health, the Department of Veterans Affairs, the John A. Hartford
Foundation and a Paul B. Beeson Physician Faculty Scholars in Aging
Research award.
Reference: American Heart Journal, Volume 152, Issue 6, Pages 1028-1034
(December 2006).
--------------------------------------------------------------------------------
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://jesuswasavegetarian.7h.com
Man Is A Herbivore!
http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING
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| Guest |
| Posted: Tue Dec 19, 2006 11:51 pm |
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Quote: ironjustice wrote:
In fact, this increased risk may help explain a longstanding medical
mystery: why women bypass patients are more likely than men to die in
the first few months after surgery.<<
Let's .. be .. clear ..
'They' .. said ..
"we've been killing our women" ..
I assume this means .. apology and regrets .. go without saying ..
Any arguments .. ?
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://jesuswasavegetarian.7h.com
Man Is A Herbivore!
http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk |
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| Manky Badger |
| Posted: Wed Dec 20, 2006 4:56 pm |
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Guest
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<ironjustice@cashette.com> wrote in message
news:1166586660.813650.188050@48g2000cwx.googlegroups.com...
Quote:
ironjustice wrote:
In fact, this increased risk may help explain a longstanding medical
mystery: why women bypass patients are more likely than men to die in
the first few months after surgery.
Let's .. be .. clear ..
'They' .. said ..
"we've been killing our women" ..
I assume this means .. apology and regrets .. go without saying ..
Any arguments .. ?
Yes, but trying to reason with you has in the past been rather futile.
Are you open to a reasoned discussion this time around ? |
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