Study examines outcomes of patients who refuse transfusion following cardiac surgery

Jehovah's Witness patients who undergo cardiac surgery do not appear to be at increased risk for surgical complications or death when compared to patients who undergo cardiac surgery and receive blood transfusions, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.

Jehovah's Witness patients (Witnesses) hold beliefs that disallow blood product transfusion and encourage the use of a number of blood , according to background information in the article.

Gregory Pattakos, M.D., M.S., of the Cleveland Clinic, Ohio, and colleagues sought to compare morbidity and long-term of Witnesses undergoing with a similarly matched group of patients who received blood transfusions.

The authors found that after propensity matching, Witnesses (322 patients) and non-Witnesses (322 patients) had similar risks for hospital mortality, but Witnesses had significantly lower occurrence of additional operation for bleeding, and sepsis compared with non-Witnesses who received transfusions.

Witnesses had fewer acute complications, including (heart attack), additional operations for bleeding and prolonged ventilation. Witnesses also had shorter hospital lengths of stay compared with matched patients who received transfusions, as well as shorter lengths of stay.

Additionally, Witnesses had higher survival rates compared with non-Witnesses at one-year (95 percent vs. 89 percent) but both groups had similar 20-year survival rates (34 percent vs. 32 percent).

The authors conclude that the Jehovah's Witness patients undergoing cardiac surgery at the Cleveland Clinic experienced similar or better short- and long-term survival than non-Witnesses. "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," they conclude.

In an invited commentary, Victor A. Ferraris, M.D., Ph.D., of the University of Kentucky Chandler Medical Center, Lexington, notes that 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."

Ferraris continues saying, "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," he concludes.

More information: Arch Intern Med. Published online July 2, 2012. doi:10.1001/archinternmed.2012.2449
Arch Intern Med. Published online July 2, 2012. doi:10.1001/archinternmed.2012.2458

Related Stories

Australian court overrules parents in cancer case

Jun 02, 2012

An Australian court ordered the parents of a cancer-stricken child to put aside their religious beliefs and allow her life-saving treatment including a blood transfusion, reports said Saturday.

Blood transfusions associated with infection

Jul 31, 2009

A study of almost 25,000 coronary artery bypass graft (CABG) patients has shown that receiving blood from another person is associated with a two-fold increase in post-operative infection rates. The research, published in ...

Recommended for you

Barriers preventing post-stroke care

Jul 24, 2014

For stroke victims, rehabilitation is crucial to their recovery. But a Flinders University study conducted in Singapore found that rehabilitation rates following discharge from hospital are poor because of gaps in the continuum ...

Home-based rehabilitation for CVD patients

Jul 24, 2014

Patients who are found to suffer from cardiovascular diseases often have long years of treatment ahead of them and are urged to drastically change their lifestyle. But what is probably the most difficult ...

User comments

Adjust slider to filter visible comments by rank

Display comments: newest first

DanielHaszard
not rated yet Jul 10, 2012
Jehovah's Witnesses blood transfusion confusion

It is misleading to imply that there is NO RISK refusing blood transfusions which is how the Jehovah's Witnesses Watchtower will spin it.
It's only *elective surgery* for patients who are not in ER bleeding to death and in a modern hospital that has all the latest blood conservation gadgets.
More than 50,000 Jehovah's Witnesses dead from Watchtowers deadly arbitrary blood ban. That is 50 times more than died at Jonestown massacre,some estimates run as high as 100,000 dead
--
Danny Haszard