Blood products and their transfusion represent significant expense to hospitals. As health care systems look toward more affordable, higher-quality care, better management of our blood supply offers significant opportunity to contribute to these goals. Audits have demonstrated that 15% to 30% of blood products are used outside of evidence-based guidelines.1 A recent JAMA article2 demonstrated hospital variability in blood use in adult cardiac surgery; rates of transfusion ranged from 7.8% to 92.8% for red cells, 0% to 97.5% for plasma, and 0.4% to 90.4% for platelets. This high variability reflects the variability that exists in health care overall, for instance, variability in surgical approach to total hip replacement (1-hole minimally invasive approach or 2-hole minimally invasive approach vs open approach); thrombosis prophylaxis (warfarin or aspirin vs low-molecular-weight heparin); anesthetic management (general anesthesia or spinal anesthesia vs peripheral nerve blocks); and how surgeons perform transfusions in their patients. Additionally, allogeneic transfusion has been associated with increased infection rates, length of stay, and mortality,3 although these outcomes may relate to other factors.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Surgery editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 3
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.