Gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study
Objectives: A post hoc gender comparison of transfusion-related modifiable risk factors among patients undergoing elective surgery. Settings: 23 Austrian centres randomly selected and stratified by region and level of care. Participants: We consecutively enrolled in total 6530 patients (3465 women a...
| Main Authors: | , , , , |
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| Format: | Journal Article |
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BM J Group
2016
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| Online Access: | http://bmjopen.bmj.com/content/6/12/e012210 http://hdl.handle.net/20.500.11937/21672 |
| _version_ | 1848750655443828736 |
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| author | Gombotz, H. Schreier, G. Neubauer, S. Kastner, P. Hofmann, Axel |
| author_facet | Gombotz, H. Schreier, G. Neubauer, S. Kastner, P. Hofmann, Axel |
| author_sort | Gombotz, H. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objectives: A post hoc gender comparison of transfusion-related modifiable risk factors among patients undergoing elective surgery. Settings: 23 Austrian centres randomly selected and stratified by region and level of care. Participants: We consecutively enrolled in total 6530 patients (3465 women and 3065 men); 1491 underwent coronary artery bypass graft (CABG) surgery, 2570 primary unilateral total hip replacement (THR) and 2469 primary unilateral total knee replacement (TKR).Main outcome measures: Primary outcome measures were the number of allogeneic and autologous red blood cell (RBC) units transfused (postoperative day 5 included) and differences in intraoperative and postoperative transfusion rate between men and women. Secondary outcomes included perioperative blood loss in transfused and non-transfused patients, volume of RBCs transfused, perioperative haemoglobin values and circulating red blood volume on postoperative day 5. Results: In all surgical groups, the transfusion rate was significantly higher in women than in men (CABG 81 vs 49%, THR 46 vs 24% and TKR 37 vs 23%). In transfused patients, the absolute blood loss was higher among men in all surgical categories while the relative blood loss was higher among women in the CABG group (52.8 vs 47.8%) but comparable in orthopaedic surgery. The relative RBC volume transfused was significantly higher among women in all categories (CABG 40.0 vs 22.3; TKR 25.2 vs 20.2; THR 26.4 vs 20.8%). On postoperative day 5, the relative haemoglobin values and the relative circulating RBC volume were higher in women in all surgical categories. Conclusions: The higher transfusion rate and volume in women when compared with men in elective surgery can be explained by clinicians applying the same absolute transfusion thresholds irrespective of a patient’s gender. This, together with the common use of a liberal transfusion strategy, leads to further overtransfusion in women. |
| first_indexed | 2025-11-14T07:40:17Z |
| format | Journal Article |
| id | curtin-20.500.11937-21672 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:40:17Z |
| publishDate | 2016 |
| publisher | BM J Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-216722017-09-13T13:53:06Z Gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study Gombotz, H. Schreier, G. Neubauer, S. Kastner, P. Hofmann, Axel Objectives: A post hoc gender comparison of transfusion-related modifiable risk factors among patients undergoing elective surgery. Settings: 23 Austrian centres randomly selected and stratified by region and level of care. Participants: We consecutively enrolled in total 6530 patients (3465 women and 3065 men); 1491 underwent coronary artery bypass graft (CABG) surgery, 2570 primary unilateral total hip replacement (THR) and 2469 primary unilateral total knee replacement (TKR).Main outcome measures: Primary outcome measures were the number of allogeneic and autologous red blood cell (RBC) units transfused (postoperative day 5 included) and differences in intraoperative and postoperative transfusion rate between men and women. Secondary outcomes included perioperative blood loss in transfused and non-transfused patients, volume of RBCs transfused, perioperative haemoglobin values and circulating red blood volume on postoperative day 5. Results: In all surgical groups, the transfusion rate was significantly higher in women than in men (CABG 81 vs 49%, THR 46 vs 24% and TKR 37 vs 23%). In transfused patients, the absolute blood loss was higher among men in all surgical categories while the relative blood loss was higher among women in the CABG group (52.8 vs 47.8%) but comparable in orthopaedic surgery. The relative RBC volume transfused was significantly higher among women in all categories (CABG 40.0 vs 22.3; TKR 25.2 vs 20.2; THR 26.4 vs 20.8%). On postoperative day 5, the relative haemoglobin values and the relative circulating RBC volume were higher in women in all surgical categories. Conclusions: The higher transfusion rate and volume in women when compared with men in elective surgery can be explained by clinicians applying the same absolute transfusion thresholds irrespective of a patient’s gender. This, together with the common use of a liberal transfusion strategy, leads to further overtransfusion in women. 2016 Journal Article http://hdl.handle.net/20.500.11937/21672 10.1136/bmjopen-2016-012210 http://bmjopen.bmj.com/content/6/12/e012210 http://creativecommons.org/licenses/by-nc/4.0/ BM J Group fulltext |
| spellingShingle | Gombotz, H. Schreier, G. Neubauer, S. Kastner, P. Hofmann, Axel Gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study |
| title | Gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study |
| title_full | Gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study |
| title_fullStr | Gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study |
| title_full_unstemmed | Gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study |
| title_short | Gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study |
| title_sort | gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study |
| url | http://bmjopen.bmj.com/content/6/12/e012210 http://hdl.handle.net/20.500.11937/21672 |