Association of Allogeneic Red-Blood Cell Transfusion with Surgeon Case-Volume

作者：Julius Cuong Pham^*; Haut Elliott R; Catlett Christina L; Berenholtz Sean M

来源：Journal of Surgical Research, 2012, 173(1): 135-144.

DOI：10.1016/j.jss.2010.08.030

• transfusion
• case volume
• red blood cell
• practice variation

Background. Surgeon case-volume predicts a variety of patient outcomes. We hypothesize that surgeon case-volume predicts RBC transfusion across different surgical procedures.
Methods. We performed a cohort study of 372,670 inpatient surgical cases in the 52 non-federal hospitals in Maryland between 2004 and 2005. The main outcome measure was relative risk of receiving a transfusion.
Results. Overall, 13.9% of patients received a transfusion. Patients seen by the highest case-volume surgeons (> 161 cases/y) were more likely to receive a transfusion (16% versus 11%, P < 0.01) compared with middle case-volume surgeons (89-161 cases/y). After adjusting for confounders, the highest case-volume patients were still at increased risk of transfusion [relative risk (RR) 1.10, 1.07-1.14]. This result was true across many surgery types.
Conclusions. Surgeon case-volume is independently associated with the likelihood of RBC transfusion across a broad range of surgical procedures. Future efforts should be directed towards studying and standardization of transfusion practices.

• 出版日期2012-3