Association of allogeneic red-blood cell transfusion with surgeon case-volume

J Surg Res. 2012 Mar;173(1):135-44. doi: 10.1016/j.jss.2010.08.030. Epub 2010 Sep 16.

Abstract

Background: Surgeon case-volume predicts a variety of patient outcomes. We hypothesize that surgeon case-volume predicts RBC transfusion across different surgical procedures.

Methods: We performed a cohort study of 372,670 in-patient surgical cases in the 52 non-federal hospitals in Maryland between 2004 and 2005. The main outcome measure was relative risk of receiving a transfusion.

Results: Overall, 13.9% of patients received a transfusion. Patients seen by the highest case-volume surgeons (>161 cases/y) were more likely to receive a transfusion (16% versus 11%, P < 0.01) compared with middle case-volume surgeons (89-161 cases/y). After adjusting for confounders, the highest case-volume patients were still at increased risk of transfusion [relative risk (RR) 1.10, 1.07-1.14]. This result was true across many surgery types.

Conclusions: Surgeon case-volume is independently associated with the likelihood of RBC transfusion across a broad range of surgical procedures. Future efforts should be directed towards studying and standardization of transfusion practices.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Erythrocyte Transfusion / statistics & numerical data*
  • Female
  • General Surgery / statistics & numerical data*
  • Humans
  • Male
  • Maryland
  • Middle Aged
  • Models, Statistical
  • Retrospective Studies
  • Risk Factors
  • Surgery Department, Hospital / statistics & numerical data*