Red blood cell transfusion practices amongst Canadian anesthesiologists: a survey.
OBJECTIVE
To assess red blood cell transfusion practices among Canadian anesthesiologists.


METHODS
A survey depicting three realistic clinical scenarios of elective surgical procedures with different risks of bleeding was administered to all Canadian practicing members (n = 2,100) of the Canadian Anesthesiologists' Society. Respondents were requested to choose hemoglobin thresholds for which they would transfuse red blood cells under various conditions within each scenario.


RESULTS
We obtained a response rate of 47% (719/1,512). Transfusion thresholds differed significantly between baseline scenarios. A threshold above 70 g x L(-1) was chosen by 48% of respondents in the general surgery scenario compared to 56% in the orthopedic surgery scenario and 79% in the vascular surgery scenario (P < 0.001). A history of coronary artery disease was associated with a transfusion threshold >or= 100 g x L(-1) in a significant proportion of respondents ranging from 20% in the orthopedic surgery scenario to 31% in the general surgery scenario and to 49% in the vascular surgery scenario (P < 0.001). Conversely, changing the patient's age from 60 to 20 yr resulted in the adoption of a transfusion threshold <or= 60 g x L(-1) by > 30% of respondents in two scenarios (P < 0.001). The year of respondent graduation was strongly associated with these findings.


CONCLUSIONS
There was significant variation in transfusion practices among Canadian anesthesiologists. The type of surgical procedure, patient's age and a history of coronary artery disease influenced reported transfusion threshold. Practice variation in specific subgroups would support the need for further research to identify optimal transfusion thresholds.
Turgeon
Alexis F
AF
Critical Care Medicine Program, University of Ottawa, Ottawa, Ontario, Canada.
Fergusson
Dean A
DA
Doucette
Steve
S
Khanna
Madhu Priya
MP
Tinmouth
Alan
A
Aziz
Ashique
A
Hébert
Paul C
PC
D000776:Anesthesiology / Q000706:statistics & numerical data*; D002170:Canada; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends