Aim Is for Better Outcomes in Anemic Surgical Patients with Fewer Transfusion-Related Complications, According to Study Presented at 93rd AATS Annual Meeting
Newswise — Minneapolis, MN, May 6, 2013 – Anemia increases operative mortality and morbidity in non-cardiac and cardiac surgical procedures. Anemic surgical patients may require more blood transfusions, raising the risk of transfusion-related complications and increasing costs. For those reasons, optimizing patient readiness by correcting anemia prior to surgery is an important clinical goal. A simple new protocol has been proposed that helps correcting anemia using a single, high dose of recombinant human erythropoietin (HRE) administered only two days prior to surgery. The results of a randomized study will be presented by Luca Weltert, MD, Cardiac Surgery Department of the European Hospital in Rome, during the Plenary Scientific Session of the 93rd AATS Annual Meeting in Minneapolis.
HRE, a red blood cell growth factor, can offset anemia, but previous protocols required that HRE must be given many days or even weeks before surgery following a complicated dosage regimen. Practically, patients often do not have that much time for preparation, and sometimes surgery must be delayed, increasing hospital costs.
In this single-blind randomized study of 600 patients presenting for heart surgery, 300 patients received a single dose of HRE 80,000 UI as a bolus two days prior to surgery and 300 patients served as controls. The results showed that prior administration of HRE reduced transfusion requirements by about one third, from a mean of 1.12 blood units per patient to 0.39 blood units per patient (p<0.001). In the control group, 39% of patients required a transfusion, compared to 17% of those who received HRE. Mean hemoglobin levels on postop day 4 were significantly higher in the HRE group (9.02 vs. 10.21 g/dl, p=0.02). No differences between groups were found for mortality or adverse events.
The HRE protocol also resulted in cost savings, according to Dr. Weltert. Taking into account the costs of HRE, the cost of a blood transfusion (blood and labor costs), and the savings from avoiding blood transfusions, Dr. Weltert found that the HRE protocol was cost-effective.
“HRE therapy remains a viable, yet underused option, a milestone in the ‘bloodless story.’ In the past its role was predominantly in association with preoperative autologous blood donation, while in the present its role has to be focused on the management of perioperative anemia,” says Dr. Weltert.
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NOTES FOR EDITORS “Single High Dose of Erythropoietin Two Days Before Surgery: A Simplified Short Term Approach to Blood Spare,” by Luca Weltert, MD, Beatrice Rondinelli, MD, Mauro Falco, MD, Alessandro Bellisario, MD, Daniele Maselli, MD, Luca Pierelli, MD, and Ruggero De Paulis, MD. Presentation at the 93rd AATS Annual Meeting. May 4-8, 2013. Minneapolis, MN, during the Plenary Scientific Session on May 6, 8:45 AM CT. http://aats.org/annualmeeting/
For more information contact Nicole Baritot, Associate Managing Editor, AATS Scientific Publications, at +1 978-299-4520 or [email protected]. Journalists wishing to interview Dr. Weltert may contact him directly at +393478880617 or [email protected].
ABOUT THE AUTHORSLuca Weltert, MD, Cardiac Surgery Department, European Hospital, Rome, ItalyBeatrice Rondinelli, MD, Transfusion Medicine Department, San Camillo-Forlanini, Rome, ItalyMauro Falco, MD, Anaesthesiology Department, European Hospital, Rome, ItalyAlessandro Bellisario, MD, Cardiac Surgery Department, European Hospital, Rome, ItalyDaniele Maselli, MD, Cardiac Surgery Department, European Hospital, Rome, ItalyLuca Pierelli, MD, Transfusion Medicine Department, San Camillo-Forlanini, Rome, ItalyRuggero De Paulis, MD, Cardiac Surgery Department, European Hospital, Rome, Italy
ABOUT THE AMERICAN ASSOCIATION FOR THORACIC SURGERY (AATS)The American Association for Thoracic Surgery (AATS) is an international organization of over 1,300 of the world’s foremost thoracic and cardiothoracic surgeons, representing 35 countries. AATS encourages and stimulates education and investigation into the areas of intrathoracic physiology, pathology and therapy. Founded in 1917 by a respected group of the last century’s earliest pioneers in the field of thoracic surgery, the AATS’ original mission was to “foster the evolution of an interest in surgery of the Thorax.” One hundred years later, the AATS continues to be the premiere association among cardiothoracic surgeons. The purpose of the Association is the continual enhancement of the ability of cardiothoracic surgeons to provide the highest level of quality patient care. To this end, the AATS encourages, promotes, and stimulates the scientific investigation and study of cardiothoracic surgery. Visit www.aats.org.
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