An Assessment of Clinician and Patient Baseline Knowledge and Preferences Regarding Red Blood Cell Transfusions in Cardiac and Non-Cardiac Surgery

Abstract

Purpose: To delineate the current knowledge of, and preference for perioperative red blood cell transfusion by clinician and patients. 
Methods: In this single center study, clinicians and patients were asked to complete a 21-item survey, and a 19-item survey, respectively. 

Results: On a 7-point category scale, clinicians felt more knowledgeable about when red blood cells should be transfused (5.5 vs 2.1; p<0.0001), clinicians, in preparation for open heart surgery, were more interested in hearing about the risks and benefits of a blood transfusion (4.6 vs 2.6; p<0.0001), and more clinicians felt it was important for them to be involved in deciding whether they should receive a blood transfusion (5.7 vs 5.0; p=0.015). The majority of clinicians chose hemoglobin triggers of either <7.5 mg/dL for non-cardiac surgery or 7.5-8.9 mg/dL for cardiac surgery, while patients either felt they did not have enough information or did not know.

Conclusion: Our results highlight important differences between clinicians and patients in the basic knowledge about, and preferences for perioperative red blood transfusion, and imply a clinician-driven decision model to transfuse RBCs, and supports future efforts to develop decision aids to facilitate patient involvement in the shared decision-making about perioperative transfusion.