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Preoperative transfusion in sickle cell disease: a survey of practice in England
Author(s) -
Buck Jackie,
Casbard Angela,
Llewelyn Charlotte,
Johnson Tony,
Davies Sally,
Williamson Lorna
Publication year - 2005
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2005.00412.x
Subject(s) - medicine , complication , blood transfusion , exchange transfusion , logistic regression , elective surgery , surgery , disease , pediatrics
Objectives : To gather data on current preoperative transfusion practice and postoperative complications in sickle cell disease (SCD) as a prelude to a randomised trial. Methods : A prospective one year survey of 114 SCD patients undergoing elective surgery in 31 English hospitals was undertaken. Results : 43%, 39% and 23% of patients, respectively, received no transfusion, top‐up and exchange transfusion preoperatively. Overall postoperative complication rates were 18%, 26% and 17%, with HbSC/HbSß + thalassaemia and 71% of obstetric and gynaecology patients were not transfused preoperatively, whereas 59% patients undergoing ENT procedures and 83% of hip replacements had top‐up and exchange transfusions respectively. Multivariable logistic regression analysis revealed that having moderate/high risk procedures was a predictor of postoperative complications (OR 4.9 (95% Cl: 1.3 to 18), P = 0.017) while preoperative transfusion was not (OR 1.7, (95% Cl: 0.5 to 6), P = 0.41). Conclusion : The lack of clear benefit of transfusion confirms the need for a randomised controlled trial of transfusion vs. no transfusion in patients with HbSS and HbSß 0 thalassaemia.