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Preoperative transfusion in sickle cell disease: a survey of practice in England

Buck, Jackie, Casbard, Angela C., Llewelyn, Charlotte, Johnson, Tony, Davies, Sally and Williamson, Lorna 2005. Preoperative transfusion in sickle cell disease: a survey of practice in England. European Journal of Haematology 75 (1) , pp. 14-21. 10.1111/j.1600-0609.2005.00412.x

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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 HbSß0thalassaemia.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RC Internal medicine
Uncontrolled Keywords: sickle cell disease; blood transfusion; preoperative; survey; postoperative complications
Publisher: Wiley-Blackwell
ISSN: 0902-4441
Last Modified: 04 Jun 2017 06:25

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