Although numerous transfusion guidelines do not state that the patient’s age should be a primary consideration in the decision to transfuse, researchers analyzing retrospective data from over 20,000 patients found that surgery patients 65 years or older had a 62% greater odds (odds ratio, 1.62; 95% confidence intervals, 1.40-1.88; p<0.0001) of undergoing transfusions than younger patients even after adjusting for comorbidities, type of surgical service, hemoglobin values, blood loss during surgery, and random effects from the surgeon and procedure.
When patients were stratified by their lowest hemoglobin values, the odds of transfusion almost always increased with age, except for those patients whose hemoglobin values did not fall below 10g/dL. Further research is needed, but a restrictive transfusion strategy is likely advantageous for most patients.
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