Americans Get Unneeded Blood Transfusions

Heart patients in the United States receive H more blood transfusions than heart patients in many other countries, which may indicate that doctors in this country are too liberal in recommending this procedure, researchers say.

The Research

Researchers at Duke Clinical Research Institute in Durham, North Carolina, analyzed 24,00 0 patient records from 16 countries and found that transfusion rates for US heart patients were 84% higher than in Europe,72% higher than in Canada, 70% higher than in Australia, New Zealand and Latin America, and 38% higher than in Asia. South Africa was the only country that had higher transfusion rates than the US.

Transfusion Confusion

"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 US, where blood is a virtually unlimited resource, physicians are more apt to reflexively transfuse their patients," according to Duke cardiologist Dr. Sunil Rao.

However, previous research at Duke and other institutions has found that blood transfusions may not be as beneficial or benign as previously believed.

"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 says.

The Duke team cautions doctors to carefully consider the ability of patients to increase blood counts without transfusions.

"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 says.