Venous thromboembolism (VTE) is associated with 5-10% of all hospital deaths, or about 100,000 to 200,000 deaths each year in the United States. However, many of these deaths may be preventable. In order to gain a better understanding of the association between VTE and RBC transfusions, researchers used data gathered during 2014 from the American College of Surgeons National Quality Improvement Program—a prospective registry of surgery patients from 525 hospitals in North America. Risk-adjusted odds ratios were calculated from 750,937 surgery patients (56.8% women; median age 58 years) for the development of VTE including deep venous thrombosis and pulmonary embolism within 30 days of surgery. The 6.3% of patients (N=47,410) who received at least one perioperative RBC transfusion were at a two-fold increased risk of VTE (aOR= 2.1; 95% CI, 2.0-2.3) compared to surgery patients who did not receive transfusions. Furthermore, the effect of RBC transfusions was dose dependent with increased risk of VTE with each intraoperative and/or postoperative RBC transfusion event (P<0.001 for trend). While further randomized controlled trials are warranted, these results support the need for stringent perioperative RBC transfusion practices.
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