Severe Acute Blood Loss Anemia in Jehovah's Witnesses Undergoing Cardiac Surgery: Single Academic Center Experience

Helwani, Mohammad A.; Wet, Charl J. De; Pennington, Bethany; Abdulnabi, Sami; Moon, Marc R.

doi:10.1053/j.jvca.2022.10.031

Journal of Cardiothoracic and Vascular Anesthesia

2023

DOI: 10.1053/j.jvca.2022.10.031

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Severe Acute Blood Loss Anemia in Jehovah's Witnesses Undergoing Cardiac Surgery: Single Academic Center Experience

Mohammad A. Helwani

Charl J. De Wet

Bethany Pennington

et al.

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2023

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“…A 2014 single center study of 293 JW patients who declined blood transfusion revealed an overall mortality rate of 8.2%, with a twofold increased risk of death per each 1 g/dL decrease in nadir Hb (unadjusted odds ratio [OR], 1.04; 95% confidence interval [CI], 1.52-2.74; adjusted OR, 1.82; 95% CI, 1.27-2.59) [5]. A retrospective cohort study by Moon and colleagues in 2018 [6] assessed the effect of severe acute blood loss anemia (nadir hematocrit <21%) on postoperative outcomes. Among 48 JW patients who underwent cardiac surgery, 9 (18.8%) developed Volume 7; Issue 02 J Hosp Health Care Admin, an open access journal ISSN: 2688-6472 postoperative severe ABLA, and 39 (81.3%) did not.…”

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A Call for Universality of Blood Availability

2023

J Hosp Health Care Admin

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Deaths due to refusal of blood products, particularly in the Jehovah's Witness population, is a critical but under-recognized issue. There are less than 10 million JW worldwide, with 1.2 million in US. They are highly vulnerable population, with only 9% having an undergraduate college education, and their religion prohibits blood products in varying degrees. There are several media and medical journal reports of deaths among JW patients from massive hemorrhage, after delivery, motor vehicle accidents, surgical procedures, and trauma. Our goal is not to challenge the religious beliefs of the JW community, but to raise awareness of the potentially preventable deaths due to acute blood loss anemia in those who decline blood products. We are calling for proactive and preemptive management, appropriate leveraging of EMR tools for early identification, and accelerated research into hemoglobin-based oxygen carriers. These deaths should be preventable in the modern day medical landscape and healthcare personnel should be aware of these tools for pre-emptive management of those who decline blood products but are being scheduled for elective surgical procedures. "I don't want blood but I don't want to die. Make sure they do a good job"

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A Call for Universality of Blood Availability

2023

J Hosp Health Care Admin

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Caring for Jehovah's Witness Patients Undergoing Complex Cardiac Surgery

Bolliger

Erb

Tanaka

2023

Journal of Cardiothoracic and Vascular Anesthesia

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Severe Acute Blood Loss Anemia in Jehovah's Witnesses Undergoing Cardiac Surgery: Single Academic Center Experience

Cited by 2 publications

References 17 publications

A Call for Universality of Blood Availability

A Call for Universality of Blood Availability

Caring for Jehovah's Witness Patients Undergoing Complex Cardiac Surgery

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