title: Outcomes from cardiac surgery in Jehovah's witness patients: experience over twenty-one years.
abstract: BACKGROUND
  Cardiac surgery in Jehovah's Witnesses may be challenging during the operation and postoperative period given their refusal of blood products. The aim of this study was to document our center's experience with Jehovah's Witnesses undergoing major cardiac surgery and to compare surgical outcomes with a matched control group.
  
  
  METHODS
  We retrospectively reviewed the demographic, perioperative, and in-hospital postoperative data for 31 Jehovah's Witness patients undergoing surgery from 1991 to 2012 and compared findings with a control group of 62 patients of the same sex and age, who underwent the same type of operations in the same period. Early mortality, major in-hospital morbidity, laboratory findings, and hospital stays were compared between groups.
  
  
  RESULTS
  Demographic data were similar between groups, except that more patients in the Jehovah's Witness group had extracardiac arteriopathy compared with controls (p = 0.04). There was no difference in predicted mortality, calculated by the Euroscore II, between groups (2.8 ± 3.3 in study group versus 2.4 ± 2.2 in control group, p = 0.469). For postoperative outcomes, there were no differences between Jehovah's Witnesses versus controls in hospital mortality (3 % versus 2 %, p = 0.548), total drain loss (847 ± 583 mL versus 812 ± 365 mL, p = 0.721), mechanical ventilation time (1.26 ± 2.24 versus 0.89 ± 0.55 days, p = 0.218), intensive care unit stay (4.3 ± 3.9 versus 3 ± 1.4 days, p = 0.080), and hospital stay (12.9 ± 7.6 versus 10.9 ± 6.6 days, p = 0.223).
  
  
  CONCLUSIONS
  Outcomes after cardiac surgery are similar between Jehovah's Witnesses and general population, in centers applying rigorous blood patient management protocols.
authors.affiliation: Department of Cardiac Surgery, Brugmann University Hospital, Laeken, Belgium.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Marinakis
authors.affiliation: Department of Anesthesiology, Brugmann University Hospital, Laeken, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Van der Linden
authors.affiliation: Department of Cardiac Surgery, Brugmann University Hospital, Laeken, Belgium.
authors.forename: Redente
authors.initials: R
authors.lastname: Tortora
authors.affiliation: Department of Intensive Care Unit, Brugmann University Hospital, Laeken, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Massaut
authors.affiliation: Department of Intensive Care Unit, Brugmann University Hospital, Laeken, Belgium.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Pierrakos
authors.affiliation: Department of Cardiac Surgery, Brugmann University Hospital, Laeken, Belgium. pierre.wauthy@chu-brugmann.be.
authors.forename: Pierre
authors.initials: P
authors.lastname: Wauthy
mesh_terms: D001530:Belgium / Q000453:epidemiology; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D006348:Cardiac Surgical Procedures / Q000379:methods; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000601:surgery; D016022:Case-Control Studies; D001026:Coronary Artery Bypass; D003710:Demography; D005260:Female; D006801:Humans; D033221:Jehovah's Witnesses; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Bleeding; Blood transfusion; Cardiopulmonary bypass; Cell saver; Reoperation