Blood Transfusions: Gender Differences in Utilization, Predictors, and Outcomes

Summary

Principal Investigator: Mary A M Rogers
Abstract: DESCRIPTION (provided by applicant): Blood transfusion is the most common ICD-9-coded procedure performed in women during hospitalization in the United States. Transfusions are more frequent in women than men since the criteria for prescribing a transfusion often rests with threshold levels of hematocrit or hemoglobin which are normally lower in women. While transfusions have been considered life- saving in patients with significant blood loss, there is increasing evidence of immunomodulatory effects and thrombosis after transfusion. Unfortunately, there are no population-based reports on the characteristics of people who receive blood transfusions in the United States and little research regarding gender-specific outcomes during the post-transfusion period. A cohort study is proposed to examine the profiles of women and men who receive transfusions and gender- specific post-transfusion outcomes. Subjects will be a representative sample of Americans, ages 65 years and older, who were enrolled in fee-for-service Medicare programs. There are three specific aims: (1) to examine the variability in blood transfusion by subject characteristics, type of provider, and region in a representative sample of elderly Americans;(2) to assess the risk of infection after allogeneic blood transfusion in women and men;and (3) to assess the risk of thrombotic events after allogeneic blood transfusion in women and men. Linked files from the nationally-representative Health and Retirement Study (HRS) and the Medicare data will be used. This will include Center for Medicare and Medicaid Services (CMS) data for hospital stays, physician visits, home health services, skilled nursing facility stays, visits to outpatient clinics and ambulatory surgical centers, emergency department visits, hospice services, and clinical laboratory services from 1991 through 2007. Information regarding blood transfusion, infection, and thrombotic events (deep-vein thrombosis, pulmonary embolism, transient ischemic attack, stroke, and myocardial infarction) will be extracted from CMS files. Data regarding demographic information, lifestyle factors, disabilities, and medical history will be obtained from the HRS. Statistical analyses will involve weighting to account for the sampling design of the HRS and the results will be presented as national estimates of blood utilization for elderly women and men in the United States. Public Health Relevance: This study will provide the public, clinicians, and policy-makers with information regarding blood utilization, predictors of blood transfusion, and outcomes associated with blood transfusion in elderly women and men in the United States.
Funding Period: ----------------2009 - ---------------2011-
more information: NIH RePORT

Top Publications

  1. pmc Acute infection contributes to racial disparities in stroke mortality
    Deborah A Levine
    From the Departments of Internal Medicine D A L, K M L, M A M R and Neurology and Stroke Program D A L, and the Institute for Social Research K M L, University of Michigan, Ann Arbor and the HSR and D Center for Clinical Management Research D A L, K M L, Veterans Affairs Ann Arbor Healthcare System, MI
    Neurology 82:914-21. 2014
  2. ncbi Health care-associated infection after red blood cell transfusion: a systematic review and meta-analysis
    Jeffrey M Rohde
    University of Michigan, Division of General Medicine, Department of Internal Medicine, Ann Arbor
    JAMA 311:1317-26. 2014
  3. pmc Utilization of blood transfusion among older adults in the United States
    Mary A M Rogers
    Department of Internal Medicine and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan 48109 0429, USA
    Transfusion 51:710-8. 2011
  4. pmc An association of ABO non-identical platelet and cryoprecipitate transfusions with altered red cell transfusion needs in surgical patients
    Majed A Refaai
    Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY, USA
    Vox Sang 101:55-60. 2011
  5. pmc Antigenic challenge in the etiology of autoimmune disease in women
    Mary A M Rogers
    Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109 0429, USA
    J Autoimmun 38:J97-J102. 2012
  6. pmc Triggers of hospitalization for venous thromboembolism
    Mary A M Rogers
    Department of Internal Medicine, University of Michigan, Ann Arbor, 48109 5429, USA
    Circulation 125:2092-9. 2012

Scientific Experts

  • Mary Am Rogers
  • Deborah A Levine
  • Kenneth M Langa
  • Jeffrey M Rohde
  • Neil Blumberg
  • Majed A Refaai
  • Latoya Kuhn
  • Derek E Dimcheff
  • Sanjay Saint
  • Andrew Hickner
  • James P Corsetti
  • Brian H Smith
  • Edward Masel
  • Richard P Phipps
  • Lawrence B Fialkow
  • Charles W Francis
  • Paul E Bankey
  • Sherry L Spinelli
  • Joanna M Heal
  • Kelly F Henrichs

Detail Information

Publications8

  1. pmc Acute infection contributes to racial disparities in stroke mortality
    Deborah A Levine
    From the Departments of Internal Medicine D A L, K M L, M A M R and Neurology and Stroke Program D A L, and the Institute for Social Research K M L, University of Michigan, Ann Arbor and the HSR and D Center for Clinical Management Research D A L, K M L, Veterans Affairs Ann Arbor Healthcare System, MI
    Neurology 82:914-21. 2014
    ..It is unknown whether racial differences in exposure to acute precipitants of stroke, specifically infection, contribute to racial disparities in stroke mortality...
  2. ncbi Health care-associated infection after red blood cell transfusion: a systematic review and meta-analysis
    Jeffrey M Rohde
    University of Michigan, Division of General Medicine, Department of Internal Medicine, Ann Arbor
    JAMA 311:1317-26. 2014
    ..The association between red blood cell (RBC) transfusion strategies and health care-associated infection is not fully understood...
  3. pmc Utilization of blood transfusion among older adults in the United States
    Mary A M Rogers
    Department of Internal Medicine and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan 48109 0429, USA
    Transfusion 51:710-8. 2011
    ..While there have been epidemiologic studies of blood donors, the characteristics of individuals who receive transfusions have not been well described for the US population...
  4. pmc An association of ABO non-identical platelet and cryoprecipitate transfusions with altered red cell transfusion needs in surgical patients
    Majed A Refaai
    Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY, USA
    Vox Sang 101:55-60. 2011
    ..Transfusion of ABO non-identical plasma, platelets and cryoprecipitate is routine practice even though adverse effects can occur...
  5. pmc Antigenic challenge in the etiology of autoimmune disease in women
    Mary A M Rogers
    Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109 0429, USA
    J Autoimmun 38:J97-J102. 2012
    ..Antigenic challenges, such as infection and allogeneic blood transfusion, are significant risk factors for the development of autoimmune disease in older women...
  6. pmc Triggers of hospitalization for venous thromboembolism
    Mary A M Rogers
    Department of Internal Medicine, University of Michigan, Ann Arbor, 48109 5429, USA
    Circulation 125:2092-9. 2012
    ..Although predictors of hospital-acquired VTE are well-known, triggers of VTE before hospitalization are not as clearly defined. The objective of this study was to evaluate triggers of hospitalization for VTE...