TY - JOUR
T1 - Autologous blood transfusion in the United States
T2 - Clinical and nonclinical determinants of use
AU - Segal, Jodi B.
AU - Guallar, Eliseo
AU - Powe, Neil R.
PY - 2001
Y1 - 2001
N2 - BACKGROUND: Preoperative donation of blood lowers the risk of allogeneic RBC transfusion. The use of autologous blood is not well quantified. This study aimed at identifying the frequency and determinants of use of autologous transfusion in the United States. STUDY DESIGN AND METHODS: This national cross-sectional study, using the Nationwide Inpatient Sample, included all patients admitted to 900 hospitals in 19 states in 1996. Logistic regression with weighting yielded nationally representative results for the independent effects of clinical and nonclinical patient characteristics on autologous blood use. RESULTS: Autologous transfusion was used in 19 of 1000 hospitalizations. The procedures using autologous blood most frequently were knee arthroplasty, hip replacement, prostatectomy, spinal fusion, and hysterectomy. Blacks and Hispanics were less likely to receive autologous transfusion than were whites (OR, 0.64; 95% Cl, 0.45-0.83); patients with Medicaid were less likely than the privately insu red to receive autologous transfusions (OR, 0.29; 95% Cl, 0.200.43), with racial differences greatest among the privately insured. Women received autologous blood for cardiovascular surgeries much less often than men (OR, 0.32; 95% Cl, 0.20-0.49). CONCLUSION: Ethnic minorities, women, and patients with Medicaid appear to receive fewer autologous blood transfusions than the rest of the population. Although this could reflect either better or worse quality of care, nonclinical determinants of transfusion practice warrant attention and further investigation.
AB - BACKGROUND: Preoperative donation of blood lowers the risk of allogeneic RBC transfusion. The use of autologous blood is not well quantified. This study aimed at identifying the frequency and determinants of use of autologous transfusion in the United States. STUDY DESIGN AND METHODS: This national cross-sectional study, using the Nationwide Inpatient Sample, included all patients admitted to 900 hospitals in 19 states in 1996. Logistic regression with weighting yielded nationally representative results for the independent effects of clinical and nonclinical patient characteristics on autologous blood use. RESULTS: Autologous transfusion was used in 19 of 1000 hospitalizations. The procedures using autologous blood most frequently were knee arthroplasty, hip replacement, prostatectomy, spinal fusion, and hysterectomy. Blacks and Hispanics were less likely to receive autologous transfusion than were whites (OR, 0.64; 95% Cl, 0.45-0.83); patients with Medicaid were less likely than the privately insu red to receive autologous transfusions (OR, 0.29; 95% Cl, 0.200.43), with racial differences greatest among the privately insured. Women received autologous blood for cardiovascular surgeries much less often than men (OR, 0.32; 95% Cl, 0.20-0.49). CONCLUSION: Ethnic minorities, women, and patients with Medicaid appear to receive fewer autologous blood transfusions than the rest of the population. Although this could reflect either better or worse quality of care, nonclinical determinants of transfusion practice warrant attention and further investigation.
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U2 - 10.1046/j.1537-2995.2001.41121539.x
DO - 10.1046/j.1537-2995.2001.41121539.x
M3 - Article
C2 - 11778069
AN - SCOPUS:0035686298
SN - 0041-1132
VL - 41
SP - 1539
EP - 1547
JO - Transfusion
JF - Transfusion
IS - 12
ER -