Association of allogeneic red-blood cell transfusion with surgeon case-volume.
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 in-patient 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.
Pham
Julius Cuong
JC
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Jpham3@jhmi.edu
Haut
Elliott R
ER
Catlett
Christina L
CL
Berenholtz
Sean M
SM
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D013502:General Surgery / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged; D015233:Models, Statistical; D012189:Retrospective Studies; D012307:Risk Factors; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*