New Study Suggests Extreme Blood Management Strategies Have Little Impact on Long-Term Mortality

A new study published in the July 2 issue of the Archives of Internal Medicine looks at whether extreme blood management strategies increase risks for surgical complications or long-term mortality.

The study compares Jehovah's Witness patients with non-Jehovah's Witness undergoing cardiac surgery. The authors note that Jehovah's Witness patients offer a unique natural experiment in severe blood conservation, not only because these patients hold beliefs that disallow blood product transfusion, but because they also follow specific process-of-care management strategies aimed at avoiding extreme anemia.

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The study found that Jehovah's Witness patients experienced similar or even better short- and long-term survival than non-Jehovah's Witnesses. Specifically, propensity-matched comparisons between Jehovah’s Witnesses and patients who received blood transfusions showed "fewer postoperative myocardial infarctions, fewer episodes of postoperative ventilator support beyond 24 hours, fewer additional operations for bleeding, shorter intensive care unit and postoperative lengths of stay, and a lower hazard for in-hospital death" among Jehovah's Witnesses.


Overall the study authors conclude that "current extreme blood management strategies do not appear to place patients at heightened risk for reduced
long-term survival." However, they note that future analyses may consider looking at which specific care-management strategies contribute to these outcomes. 

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