Racial disparities in the use of blood transfusion in major surgery.
Racial disparities in the use of blood transfusion in major surgery.
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DOI：
10.1186/1472-6963-14-121
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发表时间：
2014-03-11
影响因子：
2.8
通讯作者：
Glance LG
中科院分区：
文献类型：
--
作者：
Qian F;Eaton MP;Lustik SJ;Hohmann SF;Diachun CB;Pasternak R;Wissler RN;Glance LG
在美国，医疗保健方面的种族差异很普遍，并且有很好的记录。然而，目前尚不清楚在接受大手术的患者输血方面是否存在种族差异。我们使用大学健康系统联盟数据库（2009-2011）来检查接受冠状动脉旁路手术（CABG）、全髋关节置换术（THR）和结肠切除术患者围手术期红细胞（RBC）输注的种族差异。我们估计了多变量逻辑回归，以检查黑人患者是否比白色患者更有可能接受围手术期RBC输注，并调查种族差异的潜在来源。在调整患者水平因素后，黑人患者更有可能接受RBC输注进行CABG（AOR = 1.41，95% CI：[1.13，1.76]，p = 0.002）和THR（AOR = 1.39，95% CI：[1.20，1.62]，p < 0.001），但结肠切除术无此作用（AOR = 1.08，95% CI：[0.90，1.30]，p = 0.40）。在控制了患者保险和医院影响后，黑人和白人的输血差异仍然存在（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）。我们发现在CABG和THR中输血的使用存在种族差异（黑人患者倾向于接受比白人更多的输血），但在结肠切除术中没有。报告当代输血实践中的种族差异可能有助于减少少数民族患者可能不必要的输血。
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. 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. 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). 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.
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影响因子：
158.5
作者：
Chen, J;Rathore, SS;Krumholz, HM
通讯作者：
Krumholz, HM
影响因子：
4.3
作者：
Holman, Kerianne H.;Henke, Peter K.;Birkmeyer, John D.
通讯作者：
Birkmeyer, John D.
影响因子：
158.5
作者：
Jha, AK;Fisher, ES;Epstein, AM
通讯作者：
Epstein, AM
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
影响因子：
--
作者：
Hasnain-Wynia, Romana;Baker, David W.;Weissman, Joel S.
通讯作者：
Weissman, Joel S.