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BMC Health Services Research
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Racial disparities in the use of blood transfusion in major surgery

Authors: Feng Qian, Michael P Eaton, Stewart J Lustik, Samuel F Hohmann, Carol B Diachun, Robert Pasternak, Richard N Wissler, Laurent G Glance

Published in: BMC Health Services Research | Issue 1/2014

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Abstract

Background

Racial disparities in healthcare in the United States are widespread and have been well documented. However, it is unknown whether racial disparities exist in the use of blood transfusion for patients undergoing major surgery.

Methods

We used the University HealthSystem Consortium database (2009-2011) to examine racial disparities in perioperative red blood cells (RBCs) transfusion in patients undergoing coronary artery bypass surgery (CABG), total hip replacement (THR), and colectomy. We estimated multivariable logistic regressions to examine whether black patients are more likely than white patients to receive perioperative RBC transfusion, and to investigate potential sources of racial disparities.

Results

After adjusting for patient-level factors, black patients were more likely to receive RBC transfusions for CABG (AOR = 1.41, 95% CI: [1.13, 1.76], p = 0.002) and THR (AOR = 1.39, 95% CI: [1.20, 1.62], p < 0.001), but not for colectomy (AOR = 1.08, 95% CI: [0.90, 1.30], p = 0.40). Black-white disparities in blood transfusion persisted after controlling for patient insurance and hospital effects (CABG: AOR = 1.42, 95% CI: [1.30, 1.56], p < 0.001; THR: AOR = 1.43, 95% CI: [1.29, 1.58], p < 0.001).

Conclusions

We detected racial disparities in the use of blood transfusion for CABG and THR (black patients tended to receive more transfusions compared with whites), but not for colectomy. Reporting racial disparities in contemporary transfusion practices may help reduce potentially unnecessary blood transfusions in minority patients.
Appendix
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Metadata
Title
Racial disparities in the use of blood transfusion in major surgery
Authors
Feng Qian
Michael P Eaton
Stewart J Lustik
Samuel F Hohmann
Carol B Diachun
Robert Pasternak
Richard N Wissler
Laurent G Glance
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-121

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