title: Racial disparities in the use of blood transfusion in major surgery.
abstract: BACKGROUND
  Racial disparities in healthcare in the United States are widespread and have been well documented. However, it is unknown whether racial disparities exist in the use of blood transfusion for patients undergoing major surgery.
  
  
  METHODS
  We used the University HealthSystem Consortium database (2009-2011) to examine racial disparities in perioperative red blood cells (RBCs) transfusion in patients undergoing coronary artery bypass surgery (CABG), total hip replacement (THR), and colectomy. We estimated multivariable logistic regressions to examine whether black patients are more likely than white patients to receive perioperative RBC transfusion, and to investigate potential sources of racial disparities.
  
  
  RESULTS
  After adjusting for patient-level factors, black patients were more likely to receive RBC transfusions for CABG (AOR = 1.41, 95% CI: [1.13, 1.76], p = 0.002) and THR (AOR = 1.39, 95% CI: [1.20, 1.62], p < 0.001), but not for colectomy (AOR = 1.08, 95% CI: [0.90, 1.30], p = 0.40). Black-white disparities in blood transfusion persisted after controlling for patient insurance and hospital effects (CABG: AOR = 1.42, 95% CI: [1.30, 1.56], p < 0.001; THR: AOR = 1.43, 95% CI: [1.29, 1.58], p < 0.001).
  
  
  CONCLUSIONS
  We detected racial disparities in the use of blood transfusion for CABG and THR (black patients tended to receive more transfusions compared with whites), but not for colectomy. Reporting racial disparities in contemporary transfusion practices may help reduce potentially unnecessary blood transfusions in minority patients.
authors.affiliation: Department of Health Policy, Management, and Behavior, University at Albany School of Public Health, One University Place, GEC 169, 12144-3445 Rensselaer, NY, USA. fqian@albany.edu.
authors.forename: Feng
authors.initials: F
authors.lastname: Qian
authors.forename: Michael P
authors.initials: MP
authors.lastname: Eaton
authors.forename: Stewart J
authors.initials: SJ
authors.lastname: Lustik
authors.forename: Samuel F
authors.initials: SF
authors.lastname: Hohmann
authors.forename: Carol B
authors.initials: CB
authors.lastname: Diachun
authors.forename: Robert
authors.initials: R
authors.lastname: Pasternak
authors.forename: Richard N
authors.initials: RN
authors.lastname: Wissler
authors.forename: Laurent G
authors.initials: LG
authors.lastname: Glance
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D003082:Colectomy / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American