XXXX Versus Transfusion: Does Blood Conservation Increase the Risk of Complications?

@entity1 @entity260 @entity417 @entity130
UNASSIGNED: Orthopedic @entity130 @entity1 are routinely transfused for @entity417 even when asymptomatic at rest, despite there being relatively little scientific evidence as to what level of @entity417 can be safely tolerated. Some surgeons prefer a more liberal approach, transfusing to keep hemoglobin (Hgb) levels at 7.0 g/dL or higher; others prefer a more conservative approach, allowing Hgb levels to drop below 7.0 g/dL. We conducted a study to determine if a more conservative approach might put @entity1 at higher risk of complications of severe @entity417 . We retrospectively reviewed the cases of 104 @entity1 who were treated by a single surgeon at a level I academic @entity130 center and who were followed up for at least 1 year. @entity1 (ages 18-50 years) were divided into 2 groups by lowest Hgb level before first transfusion-under 7.0 g/dL and 7.0 g/dL or higher-and then by whether they had been transfused. Logistic regression analysis was performed. The primary outcome was @entity260 . There was no increased risk of complication related to @entity417 (P = .3). However, there was a significant risk of complication related to transfusion (P < .01). Furthermore, there was a dose-dependent effect with each unit transfused (P = .02). In young, healthy, asymptomatic @entity130 @entity1 , a more conservative transfusion strategy (vs a more liberal strategy) did not appear to carry higher risk.
