Transfusion guidelines recommend transfusing red blood cells (RBCs) when hemoglobin (Hb) levels drop below 7 or 8 g/dL, but variation in transfusion practices remain. In order to better understand racial differences in transfusions in hospitalized general medicine patients with anemia (Hb <10 g/dL) (excluding surgical, trauma, obstetrics/gynecology, cardiology, oncology, or sickle cell disease patients), researchers analyzed electronic health records from 4951 anemic patients (average age 60 years, 58% female, 71% African American, 25% white, 4% other) at the University of Chicago Medical Center. The average Hb upon admission and the nadir Hb were not significantly different based on race. Overall, white and other race patients were more likely to receive RBC transfusions compared to African Americans (p<0.01). For patients below the restrictive threshold of Hb <7 g/dL, only 80% of African Americans received transfusions compared to 86% of whites and 92% of other races (p<0.01). Additionally, for patients with a nadir above 8.0 to 8.9 g/dL Hb, only 1% of African Americans received a transfusion compared to 7% of whites and 10% of other patients (p<0.01). The impact of these racial differences in transfusion practices on patient care remains unclear. More information is needed to clarify which factors doctors consider when transfusing patients.
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