A SURVEY OF BLOOD-TRANSFUSION PRACTICES OF GYNECOLOGIC ONCOLOGISTS

Objective: To survey the attitudes of gynecologic oncologists about in dications for blood transfusion, and compare them to current recommend ations about transfusion practice. Methods: With the permission of the Society of Gynecologic Oncologists (SGO), a study questionnaire was m ailed to 548 members and candidates in their directory. The questions asked about transfusion threshold before chemotherapy, following ovari an debulking, and after endometriosis surgery. Indications for transfu sion were assessed using a qualitative/quantitative scale. Responses w ere analyzed with respect to years of SGO membership and practice sett ing using the chi(2) test and analysis of variance. Results were compa red to tile 1992 guidelines for transfusion of the American College of Physicians (ACP). Results: Two hundred eighty-five forms were returne d (52% of total). Fifty-one percent of respondents were in full-time a cademic positions; 36% were in private practice. Sixty-one percent wer e full SGO members, and 35% were candidates. The average prechemothera py transfusion threshold (TT) was a hemoglobin concentration (hgb) of 7.9 +/- 0.7 g/dl (g). At that level the mean transfusion was 1.9 +/- 0 .5 units of packed red blood cells (U). For the ovarian debulking scen ario, the mean postoperative TT was 8.1 +/- 0.8 g with a mean transfus ion of 1.9 +/- 0.4 U. For the endometriosis case, the mean TT was 7.0 +/- 0.8 g, with a mean transfusion of 1.9 +/- 0.5 U. Analysis showed n o difference in practice based on years of SGO membership or practice setting. Conclusion: A majority of the gynecologic oncologists surveye d offers transfusion at levels of anemia similar to ACP recommendation s, but frequently transfuse more units than recommended, A substantial minority does not follow the guidelines at all. (C) 1995 Academic Pre ss, Inc.