Is Blood Bad for Women?

“The odds that a woman would receive blood were more than 21 times that of men. Women were also more likely to… spend more time in intensive care and die in the hospital.”  -The New York Times

“Women have a greater post-bypass surgery mortality risk than men.”  -Mary A.M. Rogers, Ph.D

More women die after bypass surgery than men
Does this startle you? Women receive more blood transfusions while in a hospital as a result more women end up in intensive care and more women die in a hospital. 

Women need to be more proactive in this critical area of their own health care.

  • Women receive blood more often than men.
  • Women are more likely to die in the first few months after bypass surgery than men. 
  • Women stay longer in the hospital than do men.
  • Women have more complications after surgery than men.
  • Women have more post surgical infections than men.
  • More women die in the hospital than do men. 

Studies on women and blood
“Based on data from 9,218 Michigan bypass patients: Women bypass patients are more likely than men to die in the first few months after surgery.  Women are more likely to receive blood during heart bypass operations, which are performed on more than 465,000 Americans each year.”   -Science Daily

“J.R. Cerhan, of the Mayo Clinic, and colleagues from the Universities of Iowa, South Carolina, and Minnesota examined data from almost 38,000 middle-age or elderly women from Iowa to test the suggested link between allogeneic blood transfusion - receiving blood from a genetically mismatched donor - and hematologic malignancy. They found a strong association between allogeneic blood transfusions and several grades and types of lymphoma and leukemia, according to their report in Cancer Epidemiology Biomarkers and Prevention.”  -OBGYN.net

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Examine the results of one study:
• Women were 44.6 times more likely to be transfused than men.
• Blood transfusion is the most common procedure performed during hospitalization…

• The use of transfusions has increased by 64% from 1997 to 2003.
• Women were also more likely to die while in the hospital: 6.7% of women died compared with 1.3% of men.
• Blood transfusions also correlated with more days of fever more days in intensive care, and a longer hospital stay particularly if the patient got more than 4 units of blood.
• Exactly why women are more likely to receive blood transfusions is not fully understood, but, the researchers said, women typically have lower normal hemoglobin and hematocrit levels.

The study did have several limitations, the researchers noted, including the fact that they did not assess the independent effects of platelets because they were co-administered with red blood cells. They were also unable to analyze pre-storage versus post-storage filtration.

In addition, this was not a randomized controlled trial so researchers could not tease out whether the relationship between transfusion and infection was due to underlying reasons for the transfusion and not the transfusion itself.

Editor’s note: Don’t base any surgical decision based on one single study

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Other grim statistics on women’s health in the United States
Statistics on Cardiovascular disease (CVD)
♦ CVD ranks top among the disease categories for women, especially who are discharged from a hospital
♦ Heart disease is prevalent among 1 in 5 women in the US
♦ According to the US department of Health and Human Services, 1 in 3 women dies of heart disease.
♦ Another report indicates that 41.3% of all female deaths in America occur from CVD, particularly coronary heart disease (CHD) and stroke.
♦ It is also found that 38% of women compared with 25% of men will die within one year after a heart attack.
♦ Young women between the ages of 40-59 are up to 4 times more likely to die from heart bypass surgery than men of the same age.  -targetwoman.com
♦ Women undergoing heart surgery have a higher risk than men of suffering a stroke shortly after the operation.
♦ Women are up to three times more likely to die during or shortly after heart bypass surgery than men, a study reveals.
♦ 5.3% of the women died in the hospital, compared with 2.9% of the men.
♦ 3.4% of women younger than 50 died in the hospital, compared with 1.1% of men.  -BBC news

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Women bypass patients die in conventional hospitals
three times more often than men.

Why?

My Bloodless Hospital
takes care of me!

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The connection
The link between blood transfusions and post surgical mortality cannot be ignored, the data is there. Women receive more blood transfusions than men. This is a fact. Women die more often following surgery than men. Another fact- Is blood transfusion the reason? Decide for yourself.
 
In the meantime, while more data is being collected on the relationship between blood transfusion and female mortality rates, Bloodless Surgery is available right now.
 
Information on Bloodless Care from the Women’s Heart Foundation
 
Bloodless Care: What You Need to Know
Bloodless care is becoming an increasingly popular choice for women about to undergo surgery. Bloodless care can be provided safely during heart surgery - even with heart transplant surgery. In 1997, there were only about 60 institutions in the United States offering bloodless care. Due to consumer demand, these numbers are changing and more and more hospitals are learning about safer ways to administer bloodless care for women.

According to Kay Williams, C.R.N.P., Director of the Center for Bloodless Medicine and Surgery at the Pennsylvania Hospital in Philadelphia, bloodless care was started to accommodate [people with objections to blood based on religious beliefs] however, in 1997, over 30% of persons requesting bloodless care at the one Philadelphia hospital were not choosing this option for religious reasons rather to avoid the potential risk of HIV/AIDS, hepatitis and other blood-borne viruses, she said. While improved screening methods have reduced this risk, it is still a concern for many.
 
Another concern is allergic reaction. Whether you receive your own blood or the blood from another, the risk of allergic reaction is the same. Few people realize this fact. An allergic reaction can occur if a person is sensitive to the preservatives used when storing blood. Allergic reactions are considered serious and they can never be predicted.
 
Inflammatory response in patients is another concern. According to heart transplant specialist Valluvan Jeevandam, M.D. "... there are numerous inflammatory molecules that are given with the blood...They can create an inflammatory response in patients...this contributes to pulmonary dysfunction and water logging". Inflammatory response can add days to the recovery period after open heart surgery.
 
Ms. Williams clarifies that non-acceptance of blood products is not a "death wish" by the patient. "Those requesting bloodless care expect that the most advanced care be made available to them. And, the first action by the physician is always to try and stop the bleeding".

Quality alternatives to blood products

Volume expanders
Compensate for blood volume loss

Blood fractions
Albumin, Erythropoietin (EPO), immune globulin etc.

Blood conservation
  • Extra-corporeal circulation (circulation outside the body)
  • Blood Salvage (cell saver salvage machine) - A device used during a surgical procedure that returns the patient’s own blood back into to his circulatory system.
  • Intraoperative hemodilution - some of the patient's own blood is removed before surgery and replaced with a harmless non-blood solution. After surgery, the patient’s blood, which has been kept in a closed extra-corporeal system, is re-circulated back into the patient’s body. Some may object to this procedure based on religious conviction since the blood is stored outside the body.
  • Intra-operative electro-cautery or argon beam blood vessel coagulation - Special scalpels seal blood vessels as the surgeon cuts, minimizing blood loss.
  • Micro-sampling - Originally developed for infants whose circulatory systems hold a fraction of the volume of adults microsampling employs very small blood tubes to collect blood for laboratory procedures
 • Transcutaneous pulse oximetry- A small device is placed on the patient's fingertip to measure oxygen levels.
• Hypotensive anesthesia
• Hypervolemic hemodilution
• Induced hypothermia 

Helpful Links
Source Women’s Heart Foundation
Women’s Heart Foundation Medical Directive Advice
American Medical Women’s Association Advance Medical Directive

Women and Bloodless Surgery
Women in particular should be advocating Bloodless Surgery as the safest option available. They are reaping the harvest of a dismal reality – blood is bad for women. But the answer is available now. The options are there. But the choice is up to the patient.

Listen to the experts
“Women bypass patients are more likely than men to die in the first few months after surgery.”  -Science Daily 
 
“[Patients] who received blood transfusions from donors were five times more likely to die within 100 days of their operation than those who did not.” Patient Safety Enhancement Program (PSEP) at the University of Michigan Health System  -Medical News Today
 
“The rate of in-hospital death increased by 8.5 percent each additional day the transfused blood had been on the shelf.”  -New York Times, June 27, 2006
 
“Women have a greater post-bypass surgery mortality risk than men.”  -Mary A.M. Rogers, Ph.D.
 
“An epidemiologic survey of 3,534 patients in 146 western European ICUs, confirmed increased mortality rates (ICU and hospital) in transfused patients.”  -The Journal of the Society of Anesthesiologists Vol. 108 January 2008

“Five-year mortality was more than twice as high in those who received perioperative blood transfusions than in those who did not.”  -Pulmonary Reviews

“[For] patients who underwent coronary artery bypass grafting transfusion [is] associated with a 70% rise in five-year mortality.”  -Timothy Begany - Blood Transfusion: Risks And Alternatives - Pulmonary reviews.com Vol. 9, No 2 Feb 2004
 
“Patients who were given a transfusion had significantly higher mortality in intensive care and overall mortality than patients who weren’t.”  -BMJ