Post-Cardiac Op Risk Not Up for Jehovah's Witness Patients
(HealthDay News) – For Jehovah's Witness patients (Witnesses) who undergo cardiac surgery, morbidity and long-term mortality are similar or superior to that of patients who receive transfusions.
Gregory Pattakos, MD, from the Cleveland Clinic, and colleagues compared morbidity and long-term survival in 322 Witnesses undergoing cardiac surgery with a matched group of 87,453 non-Witness patients. Witnesses refused blood transfusions, while 38,467 matched patients did not receive transfusions and 48,986 did receive transfusions. The groups underwent propensity matching, and postoperative complications and long-term survival were assessed.
The researchers found that, compared with matched patients who received transfusions, Witnesses had significantly fewer acute complications (myocardial infarction, additional operation for bleeding, and prolonged ventilation) and significantly shorter intensive care unit and hospital length of stay. One-year survival was better for Witnesses (95 vs. 89%; P=0.007) but 20-year survival was similar (34 and 32%, respectively; P=0.90).
"Witnesses undergoing cardiac surgery at one major center experienced similar or even better short- and long-term survival than non-Witnesses. These patients differentiate themselves by specific process-of-care management strategies aimed at avoiding extreme anemia," the authors write. "Although we found differences in complications among Witnesses and control groups that received transfusions, current extreme blood management strategies do not appear to place patients at heightened risk for reduced long-term survival."