Evidence map›Paper›PMID 27025709›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2016

Understanding Perioperative Transfusion Practices in Gastrointestinal Surgery-a Practice Survey of General Surgeons.

Lavanya Yohanathan, Natalie G Coburn, Robin S McLeod, Daniel J Kagedan, Emily Pearsall, Francis S W Zih, Jeannie Callum, Yulia Lin, Stuart McCluskey, Julie Hallet and 1 more

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Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Evaluation of Red Blood Cell Transfusion Practice and Knowledge Among Cancer Surgeons.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021
    Article
  3. Article
  4. Article
  5. Red blood cell transfusion in liver resection.Langenbeck's archives of surgery · 2019
    Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Lavanya YohanathanDivision of General Surgery, University of Toronto, Toronto, ON, Canada.
Natalie G CoburnDivision of General Surgery, University of Toronto, Toronto, ON, Canada.
Robin S McLeodDivision of General Surgery, University of Toronto, Toronto, ON, Canada.
Daniel J KagedanDivision of General Surgery, University of Toronto, Toronto, ON, Canada.
Emily PearsallDivision of General Surgery, Mount Sinai Hospital, Toronto, ON, Canada.
Francis S W ZihDivision of General Surgery, University of Toronto, Toronto, ON, Canada.
Jeannie CallumDepartment of Clinical Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Yulia LinDepartment of Clinical Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Stuart McCluskeyDepartment of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada.
Julie HalletDivision of General Surgery, University of Toronto, Toronto, ON, Canada. julie.hallet@sunnybrook.ca.
Best Practices in General Surgery (BPIGS) group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite guidelines recommending restrictive red blood cell transfusion (RBCT) strategies, perioperative transfusion practices still vary significantly. To understand the underlying mechanisms that lead to gaps in practice, we sought to assess the attitudes of surgeons regarding the perioperative management of anemia and use of RBCT in patients having gastrointestinal surgery.

methodsWe conducted a self-administered Web-based survey of general surgery staff and residents, in a network of eight academic institutions at the University of Toronto. We developed a questionnaire using a systematic approach of items generation and reduction. We tested face and content validity and test-retest reliability. We administered the survey via emails, with planned reminders.

resultsTotal response rate was 48.1 % (62/125). Half (51.0 %) of respondents stated that they were unlikely to conduct a preoperative anemia work-up. About 54.0 % reported ordering preoperative oral iron supplementation for anemia. Most respondents indicated using a 70 g/L hemoglobin trigger (92.0 %) for transfusion. Factors increasing thresholds above 70 g/L included cardiac comorbidity (58.0 %), acute cardiac disease (94.0 %), symptomatic anemia (68.0 %), and suspected bleeding (58.0 %). With those factors, the transfusion threshold often increased above 90 g/L. Respondents perceived RBCTs to increase the postoperative morbidity (62 %), but not to impact the mortality (48 %) and cancer recurrence (52 %). Institutional protocols (68.0 %), blood conservation clinics (44.0 %), and clinical practice guidelines (84.0 %) were believed to encourage restrictive use of RBCTs.

conclusionSelf-reported perioperative transfusion practices for GI surgery are heterogeneous. Few respondents investigated preoperative anemia. Stated use of RBCT indications varied from recommendations in published guidelines for patients with symptomatic anemia. Establishing team consensus and implementing local blood management guidelines appear necessary to improve uptake of evidence-based recommendations.

Indexed as

Digestive System Surgical ProceduresErythrocyte TransfusionGeneral SurgeryPractice Patterns, Physicians'AnemiaAttitude of Health PersonnelHemoglobinsHumansInternship and ResidencyMedical Staff, HospitalPerioperative PeriodReproducibility of ResultsSurveys and QuestionnairesHemoglobinsAnemiaBloodGastrointestinalRed blood cellSurgeryTransfusion

Identifiers

PMID27025709

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.