Study: Many Blood Transfusions May Be Unnecessary
Countless blood transfusions performed in the United States each year may be unnecessary, new research suggests. That's based on statistics showing that blood transfusion rates in heart surgery patients vary considerably among hospitals nationwide, while death rates at those centers do not. The study, published in the Journal of the American Medical Association, included roughly 102,000 patients who underwent coronary artery bypass surgery at 789 U.S. sites in 2008. After examining three common transfusion types—red blood cell, fresh-frozen plasma, and platelet—researchers found "significant variability" among their use. "The absence of differences in mortality among centers with varying transfusion rates strongly suggests inappropriate transfusions," wrote the authors of an accompanying editorial. The decision over whether to perform a transfusion during bypass surgery is often complex and dependent on certain circumstances like the amount of blood loss, making rigid rules about when to transfuse difficult to determine. Still, improvement on this front is "critically important," the researchers concluded.
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If you were in need of a good hospital for top-notch heart-related care, would you go wherever your doctor sends you, figuring she knows best? That's what most people do, even though their doctors might not know best. Patients with challenging heart problems are routinely referred to hospitals with limited experience in dealing with them—situations like diagnosing and treating a rare heart rhythm, or inserting a stent in a tortuous coronary artery, or replacing a dangerously leaky aortic valve. By contrast, patients with thorny problems are not at all uncommon at the heart and heart surgery centers ranked in the latest edition of Best Hospitals, released in July by U.S. News & World Report. The bigger the problem, the more urgent the need to seek out a hospital like those in the rankings. One or more is likely to be within a short flight or a reasonable drive. The 50 heart hospitals in the latest heart rankings are scattered across 24 states and the District of Columbia, and the top 10, listed here, are in nine different pockets of the country. Following the list is guidance on understanding the qualities of an excellent heart hospital, deciding whether you need one, and explaining how to get in if you do.
The Best Hospitals in Heart & Heart Surgery
1. Cleveland Clinic
2. Mayo Clinic, Rochester, Minn.
3. Johns Hopkins Hospital, Baltimore
4. Texas Heart Institute at St. Luke's Episcopal Hospital, Houston
5. Massachusetts General Hospital, Boston
6. New York-Presbyterian University Hospital of Columbia and Cornell
7. Brigham and Women's Hospital, Boston
8. Ronald Reagan UCLA Medical Center, Los Angeles
9. Duke University Medical Center, Durham, N.C.
10. Hospital of the University of Pennsylvania, Philadelphia
[Read more: What Makes a 'Best' Heart Hospital?]
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