{"id":5128,"date":"2012-12-01T00:00:00","date_gmt":"2012-12-01T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/relationship-of-erythrocyte-transfusion-with-short-and-long-term-mortality-in-a-population-based-surgical-cohort\/"},"modified":"2023-06-14T20:11:11","modified_gmt":"2023-06-15T00:11:11","slug":"relationship-of-erythrocyte-transfusion-with-short-and-long-term-mortality-in-a-population-based-surgical-cohort","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/relationship-of-erythrocyte-transfusion-with-short-and-long-term-mortality-in-a-population-based-surgical-cohort\/","title":{"rendered":"Relationship of erythrocyte transfusion with short- and long-term mortality in a population-based surgical cohort"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; When comparing transfused versus nontransfused patients, erythrocyte transfusion is consistently associated with increased mortality. Nonetheless, unmeasured confounding may unduly influence this comparison. This unmeasured risk may have less influence on comparisons of patients undergoing surgery at hospitals with differing transfusion rates.<\/p>\n<p><strong>Methods<\/strong> &#x2014; Administrative databases were used to conduct a population-based cohort study of patients who underwent elective hip- or knee-replacement surgery from 1999 to 2008 in Ontario, Canada. The authors used Cox proportional-hazards models to determine the adjusted association of hospital-specific erythrocyte transfusion rates (i.e., comparing hospitals with differing transfusion rates) with postoperative mortality. For comparison, they also determined the adjusted association of patient receipt of transfusion (i.e., comparing transfused vs. nontransfused patients) with mortality.<\/p>\n<p><strong>Results<\/strong> &#x2014; Of 162,190 patients, 23% (n = 37,015) were transfused. Hospital-specific transfusion rates at the 66 included hospitals ranged from 10.3 to 57.9%. Compared with nontransfused patients, transfused patients experienced increased adjusted 30-day (hazard ratio 2.32; 95% CI, 1.91-2.83) and 1-yr mortality (hazard ratio 1.75; 95% CI, 1.60-1.91). However, when hospitals were categorized into quartiles based on hospital-specific transfusion rates, mortality rates were similar (highest transfusion quartile vs. lowest transfusion quartile: 30-day mortality, hazard ratio 1.11, 95% CI 0.82-1.50; 1-yr mortality, hazard ratio 1.02, 95% CI 0.82-1.26).<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; The association of transfusion with postoperative mortality differed significantly when comparing transfused versus nontransfused patients, as opposed to comparing hospitals with differing transfusion rates. This discrepancy raises questions about the true relationship between transfusion and mortality.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; When comparing transfused versus nontransfused patients, erythrocyte transfusion is consistently associated with increased mortality. Nonetheless, unmeasured confounding may unduly influence this comparison. This unmeasured risk may have less influence on comparisons of patients undergoing surgery at hospitals with differing transfusion rates. Methods &#x2014; Administrative databases were used to conduct a population-based cohort study [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[25],"migration-helper-qa-sample-set":[],"class_list":["post-5128","journal_article","type-journal_article","status-publish","hentry","topic-surgery"],"acf":{"citation":"Karkouti K, Stukel TA, Beattie WS, Elsaadany S, Li P, Berger R, Wijeysundera DN. <em>Anesthesiology<\/em>. 2012; 117(6):1175-83.","source_url":"http:\/\/anesthesiology.pubs.asahq.org\/article.aspx?articleid=1933904","ices_scientist":[1372,1132],"site":[6733],"research_program":[6740,6742],"news_release":[7475],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"BE4ED55B-FBC1-40DA-8F36-F0DEA810131E","sitecore_item_name":"Relationship-of-erythrocyte-transfusion-with-short-and-long-term-mortality-in-a-population-based","sitecore_field_values":"{\n  \"Title\": \"Relationship of erythrocyte transfusion with short- and long-term mortality in a population-based surgical cohort\",\n  \"Short title\": \"Relationship of erythrocyte transfusion\",\n  \"Citation\": \"<p>Karkouti K, Stukel TA, Beattie WS, Elsaadany S, Li P, Berger R, Wijeysundera DN. <em>Anesthesiology<\/em>. 2012; 117(6):1175-83.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; When comparing transfused versus nontransfused patients, erythrocyte transfusion is consistently associated with increased mortality. Nonetheless, unmeasured confounding may unduly influence this comparison. This unmeasured risk may have less influence on comparisons of patients undergoing surgery at hospitals with differing transfusion rates.<\/p>n<p><strong>Methods<\/strong> &mdash; Administrative databases were used to conduct a population-based cohort study of patients who underwent elective hip- or knee-replacement surgery from 1999 to 2008 in Ontario, Canada. The authors used Cox proportional-hazards models to determine the adjusted association of hospital-specific erythrocyte transfusion rates (i.e., comparing hospitals with differing transfusion rates) with postoperative mortality. For comparison, they also determined the adjusted association of patient receipt of transfusion (i.e., comparing transfused vs. nontransfused patients) with mortality.<\/p>n<p><strong>Results<\/strong> &mdash; Of 162,190 patients, 23% (n = 37,015) were transfused. Hospital-specific transfusion rates at the 66 included hospitals ranged from 10.3 to 57.9%. Compared with nontransfused patients, transfused patients experienced increased adjusted 30-day (hazard ratio 2.32; 95% CI, 1.91-2.83) and 1-yr mortality (hazard ratio 1.75; 95% CI, 1.60-1.91). However, when hospitals were categorized into quartiles based on hospital-specific transfusion rates, mortality rates were similar (highest transfusion quartile vs. lowest transfusion quartile: 30-day mortality, hazard ratio 1.11, 95% CI 0.82-1.50; 1-yr mortality, hazard ratio 1.02, 95% CI 0.82-1.26).<\/p>n<p><strong>Conclusions<\/strong> &mdash; The association of transfusion with postoperative mortality differed significantly when comparing transfused versus nontransfused patients, as opposed to comparing hospitals with differing transfusion rates. This discrepancy raises questions about the true relationship between transfusion and mortality.<\/p>n<p><a href=\"http:\/\/anesthesiology.pubs.asahq.org\/article.aspx?articleid=1933904\" title=\"Opens external link\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{9F514AF9-2526-48FE-8414-54C443CF99AD}|{249971EF-EC72-4348-B45D-57726163E9C1}\",\n  \"Related Products\": \"<h2>News Release<\/h2>rn<h3><a href=\"~\/link.aspx?_id=A18DDCA9777D4F3284D16910E41B1967&amp;_z=z\">Red blood cell transfusion appears safer than once believed: study<\/a><\/h3>\",\n  \"Research Programs\": \"{46DF28D2-EDE8-4DF2-8CC0-87CEF464E435}|{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{A0978F87-1C10-4E62-A833-89616146CA59}|{22E01D03-965E-4F09-9CC2-6BC40EC9403D}\",\n  \"Downloads\": null,\n  \"Posted Date\": \"20121201T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2012\/January\/Relationship-of-erythrocyte-transfusion-with-short-and-long-term-mortality-in-a-population-based"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Relationship of erythrocyte transfusion with short- and long-term mortality in a population-based surgical cohort<\/title>\n<meta name=\"description\" content=\"Background &#x2014; When comparing transfused versus nontransfused patients, erythrocyte transfusion is consistently associated with increased mortality.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/relationship-of-erythrocyte-transfusion-with-short-and-long-term-mortality-in-a-population-based-surgical-cohort\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Relationship of erythrocyte transfusion with short- and long-term mortality in a population-based surgical cohort\" \/>\n<meta property=\"og:description\" content=\"Background &#x2014; When comparing transfused versus nontransfused patients, erythrocyte transfusion is consistently associated with increased mortality.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/relationship-of-erythrocyte-transfusion-with-short-and-long-term-mortality-in-a-population-based-surgical-cohort\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-15T00:11:11+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/relationship-of-erythrocyte-transfusion-with-short-and-long-term-mortality-in-a-population-based-surgical-cohort\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/relationship-of-erythrocyte-transfusion-with-short-and-long-term-mortality-in-a-population-based-surgical-cohort\\\/\",\"name\":\"ICES | Relationship of erythrocyte transfusion with short- and long-term mortality in a population-based surgical cohort\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2012-12-01T05:00:00+00:00\",\"dateModified\":\"2023-06-15T00:11:11+00:00\",\"description\":\"Background &#x2014; 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