An estimated five million patients receive blood transfusion per year, and blood transfusion is the most commonly employed procedure code used among inpatient stay. About 60-70% of blood transfusions take place in surgical settings.1
Although these statistics are impressive, the presence of postanemia presents a challenge for both medical and surgical specialties. In my practice, I have always tried to follow what is considered the best practice with our current understanding of the most recent research. It would be beneficial for both specialties to discuss their different points of views and expectations on this subject to achieve better patient outcome. In order to arrive at a consensus between medical and surgical
specialties, I would like to review a few key publications, including the old practice guideline published by the American Society of Anesthesiologists in 2006 and the Canadian TRICC study published in 1999 in the NEJM, and compare these with the results from the much anticipated FOCUS study, which started in 2006, for hip fracture patients with cardiovascular disease or cardiovascular risk factors. These reviews compare different approaches in treating post-op surgical patients, such as a liberal red blood cell (RBC) transfusion strategy and aggressively treat moderate anemia, and their clinical outcomes.