John T. Kontor, MD
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Kontor JT. Erythropoietin for Total Hip Joint Arthroplasty. Ann Intern Med. 2001;135:471. doi: 10.7326/0003-4819-135-6-200109180-00019
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Published: Ann Intern Med. 2001;135(6):471.
TO THE EDITOR:
The study by Feagan and colleagues (1) provides important information about the use of erythropoietin and iron to increase preoperative hemoglobin levels and avoid blood transfusions in orthopedic patients. Unfortunately, little evidence shows that transfusions for patients such as those in the study are necessary in the first place. Existing evidence suggests that transfusions for patients with postoperative hip replacements (2, 3) and noncardiac patients in the intensive care unit (4) with hemoglobin levels of 80 to 100 g/L are of no benefit and might actually be harmful. It would be of much greater use to see this study repeated using strict criteria for transfusion indications. We should also focus on educating primary care physicians and surgeons about the appropriate indications for transfusions. This may be a safer and more cost-effective approach to avoiding the unnecessary and potentially harmful use of blood products.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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