Posts by TJ Curioso

severe blood conservation in conjunction with cardiac surgery is not associated with long-term adverse consequences, according to a new study published in archives of internal medicine.

investigators from the cleveland clinic and the nhlbi compared 322 patients who were jehovans witnesses with an equal number of matched controls.

Severe Blood Conservation Appears Safe In Cardiac Surgery For Jehovah's Witnesses

Severe blood conservation in conjunction with cardiac surgery is not associated with long-term adverse consequences, according to a new study published in Archives of Internal Medicine. ?

Investigators from the Cleveland Clinic and the NHLBI compared 322 patients who were Jehovan’s Witnesses with an equal number of matched controls. Due to their religious beliefs Witnesses do not receive blood transfusions, and therefore “provide a unique natural experiment in severe blood conservation,” according to the authors.

Compared to patients who had transfusions, Witnesses had better short term and long term outcomes. They had fewer complications in the hospital and better survival out to 15 years.

Perioperative MI: 0.31% for Witnesses versus vs 2.8% for controls (p = .01)
Operation for bleeding: 3.7% vs 7.1% (p = .03)
Prolonged ventilation: 6% vs 16% (p < .001)
Hours in the ICU (15th, 50th, and 85th percentiles): 24 versus 24, 25 versus 48, and 72 versus 162 (p < .001)
Survival at 5 years: 86% versus 74%
Survival at 10 years: 69% versus 53%
Survival at 15 years: 51% versus 35%

The investigators concluded that although they “found differences in complications among Witnesses and control groups that received transfusions, current extreme blood management strategies do not appear to place patients at heightened risk for reduced long-term survival.”

In an accompanying editorial, Victor Ferraris points out that “Witnesses who undergo cardiac surgery are likely a healthier subgroup of Witnesses because those who are believed by their surgeons to require blood transfusion to survive cardiac surgery presumably never go to the operating room.” Nevertheless, “the finding that the Witnesses who did not receive transfusions did at least as well as, if not better than, those who received a transfusion raises questions about whether more patients might benefit from surgical strategies that minimize transfusion of blood products.”

Here is the press release from Archives:

Study Examines Outcomes of Patients Who Refuse Transfusion Following Cardiac Surgery

CHICAGO– Jehovah’s Witness patients who undergo cardiac surgery do not appear to be at increased risk for surgical complications or death when compared to patients who undergo cardiac surgery and receive blood transfusions, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.

Jehovah’s Witness patients (Witnesses) hold beliefs that disallow blood product transfusion and encourage the use of a number of blood conservation practices, according to background information in the article.

Gregory Pattakos, M.D., M.S., of the Cleveland Clinic, Ohio, and colleagues, sought to compare morbidity and long-term survival rates of Witnesses undergoing cardiac surgery with a similarly matched group of patients who received blood transfusions.

The authors found that after propensity matching, Witnesses (322 patients) and non-Witnesses (322 patients) had similar risks for hospital mortality, but Witnesses had significantly lower occurrence of additional operation for bleeding, renal failure and sepsis compared with non-Witnesses who received transfusions.

Witnesses had fewer acute complications, including myocardial infarction (heart attack), additional operations for bleeding and prolonged ventilation. Witnesses also had shorter hospital lengths of stay compared with matched patients who received transfusions, as well as shorter intensive care unit lengths of stay.

Additionally, Witnesses had higher survival rates compared with non-Witnesses at one-year (95 percent vs. 89 percent) but both groups had similar 20-year survival rates (34 percent vs. 32 percent).

The authors conclude that the Jehovah’s Witness patients undergoing cardiac surgery at the Cleveland Clinic experienced similar or better short- and long-term survival than non-Witnesses. “Although we found differences in complications among Witnesses and control groups that received transfusions, current extreme blood management strategies do not appear to place patients at heightened risk for reduced long-term survival,” they conclude.

http://www.forbes.com/sites/larryhusten/2012/07/02/severe-blood-conservation-appears-safe-in-cardiac-surgery-for-jehovahs-witnesses/

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Rick Fearons wife Inez passed away

by mouthy in

jw
friends

did anyone hear that rick fearons wife inez passed away???

?.

TJ Curioso

My deepest condolences, brother Rick.

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Main article on child abuse on watchtower.org right now

by InquiryMan in

they have chosen to highlight this article on their website:.

http://www.watchtower.org/e/200710/article_01.htm.

.

TJ Curioso

HYPOCRISY!

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ok, we are all pretty hyped up now...what if the WT wins the appeal?

by Aussie Oz in

i have a saying, repeated here at times, ''the law is an ass''.. we know how excited we were when the unthank case was hot and how the magistrate slam dunked it into the trash can.

not wanting to debate the how and why's of stevens methods, just that the law had an opportunity to actually uphold the law and chose not to.

the law allowed the wt to trample on the law and did nothing.

TJ Curioso

I think that with more cases appearing, the WT will be in difficult trouble to defend themselves from this cases. If in this moment another case appear (at the same time) will be a important nail in the coffin of the Watchtower.

It will be very difficult for them to deffend littigious cases at the same cases and to the eyes of the judges they will see a pattern in Watchtower procedures.

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