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dc.contributor.authorGombotz, H.
dc.contributor.authorSchreier, G.
dc.contributor.authorNeubauer, S.
dc.contributor.authorKastner, P.
dc.contributor.authorHofmann, Axel
dc.date.accessioned2017-01-30T12:26:39Z
dc.date.available2017-01-30T12:26:39Z
dc.date.created2017-01-23T19:30:25Z
dc.date.issued2016
dc.identifier.citationGombotz, H. and Schreier, G. and Neubauer, S. and Kastner, P. and Hofmann, A. 2016. Gender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study. BMJ Open. 6: Article 3012210.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/21672
dc.identifier.doi10.1136/bmjopen-2016-012210
dc.description.abstract

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.

dc.publisherBM J Group
dc.relation.urihttp://bmjopen.bmj.com/content/6/12/e012210
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.titleGender disparities in red blood cell transfusion in elective surgery: a post hoc multicentre cohort study
dc.typeJournal Article
dcterms.source.volume6
dcterms.source.startPageArticle e012210
dcterms.source.issn2044-6055
dcterms.source.titleBMJ Open
curtin.departmentCentre for Population Health Research
curtin.accessStatusOpen access


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