Perioperative use of blood products is associated with risk of morbidity and mortality after surgery

Association between isolated abnormal coagulation profile on transfusion following major surgery: A NSQIP analysis of individuals without bleeding disorders

“…[5][6][7][8][9][10][11][12]29 However, the rationale for routine preoperative coagulation screening may be due to an institutional or physician effort to reduce or prevent the need for blood transfusion because of its association with increased postoperative morbidity and mortality in surgical patients. [30][31][32] In our study cohort of patients without a known bleeding disorder, both equivocal and/or abnormal coagulation profile were associated with major complications and mortality postoperatively. There are multiple reversal treatments (e.g., vitamin K, fresh frozen plasma [FFP], prothrombin complex concentrates [PCCs]) available to reduce the bleeding risk for surgical patients on anticoagulation to meet an acceptable level of INR <1.5.…”

“…Several observational studies and systematic reviews have evaluated the clinical utility of preoperative coagulation testing and concluded that abnormal results do not predict perioperative bleeding 5–12,29 . However, the rationale for routine preoperative coagulation screening may be due to an institutional or physician effort to reduce or prevent the need for blood transfusion because of its association with increased postoperative morbidity and mortality in surgical patients 30–32 . In our study cohort of patients without a known bleeding disorder, both equivocal and/or abnormal coagulation profile were associated with major complications and mortality postoperatively.…”

Cost of red blood cell transfusion; evaluation in a French academic hospital

“…Labile blood products (LBPs) constitute a scarce and precious resource, for which the supply is made difficult by the aging of the population. Despite its undeniable benefits and the steady improvement in its safety, transfusion remains associated with undesirable effects which justify limiting its use to what is strictly necessary (1)(2)(3)(4). Patient blood management (PBM) aims to optimize the transfusion of LBPs (restrictive strategy), develop alternatives and improve the quality of patient care, achieving a primary prevention of transfusion risks (5,6).…”

Indications and hemoglobin thresholds for red blood cell transfusion and iron replacement in adults with gastrointestinal bleeding: An algorithm proposed by gastroenterologists and patient blood management experts

“…The decision to give an RBC transfusion is challenging and should take into account individual patient characteristics, together with the source, activity, and extent of bleeding and the patient’s clinical tolerance of anemia. Several studies support the use of clinical decision-making tools to promote PBM and restrictive transfusion practices, and to improve RBC utilization, even in high-risk patients ( 33 , 50 , 74 , 91 , 116 – 118 ). In some patient groups, a restrictive strategy can reduce unnecessary use of allogeneic transfusions and is associated with equivalent or better outcomes than a liberal strategy.…”