RT Journal
A1 Angouras DC
T1 JEhovah's witnesses may not have identical outcomes with nontransfused non-witnesses after cardiac surgery
JF JAMA Internal Medicine
JO JAMA Internal Medicine
YR 2013
FD February 11
VO 173
IS 3
SP 248
OP 249
DO 10.1001/jamainternmed.2013.1626
UL http://dx.doi.org/10.1001/jamainternmed.2013.1626
AB 
In an attempt to investigate the effect of current extreme blood management strategies on outcome of patients undergoing cardiac surgery, Pattakos et al1 used, what they called, the “natural experiment” of Jehovah's Witnesses, who refuse blood transfusions owing to religious beliefs.1 They performed a statistically elaborate analysis of operative and long-term outcomes in Witnesses compared with propensity-matched patients who received transfusions. They concluded that extreme blood management strategies do not appear to place patients at heightened risk for operative mortality and morbidity nor reduce their long-term survival.1 As a matter of fact, their analysis demonstrated that Witnesses had a relatively improved overall outcome, ie, a lower operative morbidity and, in long-term follow-up, a lower risk of death in the early hazard phase. Hence, this report corroborates other observational studies indicating that transfusions are associated with negative outcomes following cardiac operations.2- 3