Transfusion thresholds in common elective surgical procedures in Finland

Background and Objectives: Transfusion practices and thresholds in common e lective surgical procedures were investigated in a nationwide multicenter s urvey in Finland, Materials and Methods: The records of 764 total hip repla cement (THR), 397 total knee replacement (TKR) and 343 transurethral resect ion of the prostate (TURP) patients were reviewed by four anesthesiologists . Results: The allogeneic red cell (RBC) transfusion rates in THR, TKR and TURF operations were 92, 84 and 18%, respectively. In THR and TKR, 74% of p atients who lost 20% or less of their blood volume during hospitalization w ere transfused with RBCs. Postoperatively, the median pretransfusion hemogl obin values were 9.6 g/dl in orthopedic operations and 10.7 g/dl in TURF. I n some hospitals, the median transfusion threshold in TURF patients was as high as 11.2 g/dl. Conclusion: The transfusion thresholds in all operations were liberal compared to recent international recommendations. Inappropria te thresholds were reflected in the high transfusion rates, This study acce ntuates the need for continuous discussion and educational measures to find optimal indications for transfusion in surgery, and to rationalize the tra nsfusion policy in Finland. Copyright (C) 2000 S. Karger AG, Basel.