Long-term survival and quality of life in Jehovah’s witnesses after cardiac surgery: a case control study

Abstract

Background We previously analyzed morbidity and mortality in Jehovah’s Witnesses patients after cardiac surgery compared to control population patients. Patients who were Jehovah’s Witnesses were operated in accordance with their philosophical convictions and in respect of their refusal of transfusions. We propose to assess long-term survival and quality of life in the patients of this preliminary study. Methods We contacted 31 adult Jehovah’s Witnesses patients who underwent heart surgery at the Brugmann hospital between 1991 and 2012 and compared them to a control population of 62 patients that had no transfusion restriction, and matched them for sex, age at the time of intervention and the type of surgery performed. We compared long-term quality of life in both populations through the MacNew software, a validated instrument to assess quality of life of patients with cardiovascular disease. The long-term survival of patients was analyzed by Kaplan Meier curves. Results Long-term quality of life and survival do not appear different between the two groups. Patient evaluation by MacNew software shows comparable physical ( p = 0.54), emotional ( p = 0.12), social ( p = 0.21) and global ( p = 0.25) scores between the two populations. The analysis of the actuarial survival curves shows no differences in terms of long-term survival of these patients ( p = 0.37). Conclusions Cardiac surgery in Jehovah’s Witnesses can be performed with identical long-term quality of life and survival compared to surgery without blood transfusion restriction, if one follows rigorous blood conserving strategies. Trial registration NCT03348072 . Retrospectively registered 16 November 2017.

Everyday Cardiac Surgery in Jehovah‘s Witnesses of Typically Advanced Age: Clinical Outcome and Matched Comparison

“…Our current study compared 32 consecutive Jehovah's Witnesses undergoing cardiac surgery with a matched cohort of non-Witnesses. Although the sample size appears relatively small, it is consistent with similar group sizes in other published studies [9,13,[15][16][17]. The small cohort was characterized by a nearly balanced gender ratio and below-average weight and BMI.…”

Mortality and morbidity in non‐transfusable and transfusable patients: A systematic review and meta‐analysis

“…More details on exclusion reason are available from Table S9, Data S1. This left 41 studies published in 42 reports meeting the criteria for inclusion in our review 14–55 …”

Outcomes of cardiac surgery in Jehovah’s Witness patients: A review

“…The authors employed the MacNew questionnaire, which showed no difference in physical (p = 0.54), emotional (p = 0.12), social (p = 0.21) and global (p = 0.25) scores between the two populations. 63…”

“…Future research is needed to provide greater clarity on the outcomes of cardiac surgery in Witnesses that refuse blood products. There needs to be an increased focus on multi-institutional studies with a greater number of participants to validate the research to date, 8,63 along with readmission rates and long term mortality following discharge, 2 and a more in depth cost analysis of pre-, intra-, and post-operative optimisation of witnesses during cardiac surgery. 8…”