Perioperative transfusion threshold : A population-based observational study

A patient’s hemoglobin (a protein in blood that carries oxygen throughout the body) influences when a clinician may administer a blood transfusion. The hemoglobin level chosen to transfuse a unit of blood is referred to as a transfusion threshold. The main objective of our research program is to identify and evaluate the optimal transfusion thresholds to use in major non-cardiac surgery. We will develop a survey and a large observational study to better understand current practices and attitudes toward research in that domain. We will then explore the effect of different transfusion thresholds on mortality and adverse effects. Our analyses will be innovative and comprehensive, accounting for several patients and surgery characteristics (e.g age, sex, type of procedure). In the long-term, we aim at providing recommendations about the optimal perioperative use of red blood cell transfusion in major non-cardiac surgery. On the patient perspective, inappropriate transfusion administration can be associated with acute and long-term harmful consequences, such as infections. For the society, transfusion is a scarce and expensive resource, and judicious use can reduce significant inequities and economic burden. For health care professionals, perioperative transfusion recommendations will provide a foundation to improve evidence-based surgical transfusion practices with a patient-centered approach.

FERGUSSON, Dean

Ottawa Hospital Research Institute

Graduate Fellowship Program

Ontario

$52,000