US heart patients receive more transfusions than international patients

DURHAM, N.C. American physicians may be too liberal in their use of blood transfusions, suggests a study by Duke Clinical Research Institute (DCRI) cardiologists. In an analysis of some 24,000 patient records, the researchers found that Americans rushed to the hospital with heart attack symptoms have significantly higher rates of bleeding and transfusions after treatment than similar patients throughout the world.

The researchers counsel physicians to be cautious against initiating transfusing, given their risks, and to take into account patients' capability for increasing blood counts without transfusions.

These findings add to the growing list of studies indicating such a disparity, said the Duke researchers. For example, they found that American heart patients receive blood transfusions 84 percent more often than Europeans and 38 percent more often than Asians after receiving the same treatments.

These findings are important, the researchers said, because research conducted over the past several years at Duke and elsewhere has found that the use of blood transfusions may not be as beneficial nor as benign as once thought, the Duke researchers said.

"There is substantial international variation in bleeding and transfusion rates among the heart patients we studied," said Duke cardiologist Sunil Rao, M.D., who presented the results of the analysis Nov. 15, 2005, at the annual scientific session of the American Heart Association in Dallas.

"These risks of bleeding remained substantially higher even after we made adjustments for patient characteristics and the use of invasive procedures," Rao continued. "Whether this variation is due to biological differences in response to anti-coagulation medications or other practice patterns deserve further study."

U.S. transfusion rates were 72 percent higher than Canada, 70 percent higher in both Australia/New Zealand and Latin American. Interestingly, the only country with highe

Contact: Richard Merritt
Duke University Medical Center

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