Marinakis Sotirios, Van der Linden Philippe, Tortora Redente, Massaut Jacques, Pierrakos Charalampos, Wauthy Pierre
Department of Cardiac Surgery, Brugmann University Hospital, Laeken, Belgium.
Department of Anesthesiology, Brugmann University Hospital, Laeken, Belgium.
J Cardiothorac Surg. 2016 Apr 14;11(1):67. doi: 10.1186/s13019-016-0455-6.
Cardiac surgery in Jehovah's Witnesses may be challenging during the operation and postoperative period given their refusal of blood products. The aim of this study was to document our center's experience with Jehovah's Witnesses undergoing major cardiac surgery and to compare surgical outcomes with a matched control group.
We retrospectively reviewed the demographic, perioperative, and in-hospital postoperative data for 31 Jehovah's Witness patients undergoing surgery from 1991 to 2012 and compared findings with a control group of 62 patients of the same sex and age, who underwent the same type of operations in the same period. Early mortality, major in-hospital morbidity, laboratory findings, and hospital stays were compared between groups.
Demographic data were similar between groups, except that more patients in the Jehovah's Witness group had extracardiac arteriopathy compared with controls (p = 0.04). There was no difference in predicted mortality, calculated by the Euroscore II, between groups (2.8 ± 3.3 in study group versus 2.4 ± 2.2 in control group, p = 0.469). For postoperative outcomes, there were no differences between Jehovah's Witnesses versus controls in hospital mortality (3 % versus 2 %, p = 0.548), total drain loss (847 ± 583 mL versus 812 ± 365 mL, p = 0.721), mechanical ventilation time (1.26 ± 2.24 versus 0.89 ± 0.55 days, p = 0.218), intensive care unit stay (4.3 ± 3.9 versus 3 ± 1.4 days, p = 0.080), and hospital stay (12.9 ± 7.6 versus 10.9 ± 6.6 days, p = 0.223).
Outcomes after cardiac surgery are similar between Jehovah's Witnesses and general population, in centers applying rigorous blood patient management protocols.
鉴于耶和华见证会成员拒绝使用血制品，其心脏手术在术中及术后可能具有挑战性。本研究的目的是记录我们中心为耶和华见证会成员实施重大心脏手术的经验，并将手术结果与匹配的对照组进行比较。
我们回顾性分析了1991年至2012年期间接受手术的31例耶和华见证会患者的人口统计学、围手术期及术后住院数据，并将结果与同期接受相同类型手术的62例同性及同龄对照组患者进行比较。比较两组之间的早期死亡率、主要院内发病率、实验室检查结果及住院时间。
两组之间的人口统计学数据相似，但与对照组相比，耶和华见证会组有更多患者患有心外动脉病变（p = 0.04）。两组之间根据欧洲心脏手术风险评估系统II计算的预测死亡率无差异（研究组为2.8±3.3，对照组为2.4±2.2，p = 0.469）。对于术后结果，耶和华见证会成员与对照组在医院死亡率（3%对2%，p = 0.548）、总引流量（847±583 mL对812±365 mL，p = 0.721）、机械通气时间（1.26±2.24天对0.89±0.55天，p = 0.218）、重症监护病房住院时间（4.3±3.9天对3±1.4天，p = 0.080）及住院时间（12.9±7.6天对10.9±6.6天，p = 0.223）方面均无差异。
在采用严格血液管理方案的中心，耶和华见证会成员心脏手术后的结果与普通人群相似。
