TY - JOUR
T1 - Facts and fears regarding blood transfusions in decision making for thrombolytic therapy
AU - Sugarman, Jeremy
AU - Powe, Neil R.
AU - Guerei, Alan D.
AU - Levine, David M.
N1 - Funding Information:
From the Divisions of aInternal Medicine and bCardiology, The Johns Hopkins University School of Medicine. Supported in part by a National Research Service Award (2T32HLO7180-NHLBI) and an American College of Physicians Teaching and Research Scholarship (Dr. Powe). Received for publication Dec. 17, 1992; accepted Jan. 25, 1993. Reprint requests: Jeremy Sugarman, MD, MPH, Division of General Internal Medicine, Box 3240, Duke University Medical Center, Durham, NC
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1993/8
Y1 - 1993/8
N2 - With current clinical strategies for managing acute myocardial infarction, red blood cell transfusions are required to treat approximately 0.6 % to 4.0 % of patients who receive thrombolytic therapy and suffer hemorrhagic complications. The actual risk of serious subsequent morbidity (e.g., AIDS or chronic hepatitis) associated with such transfusions is small, occurring in only 0.018% to 0.12 % of patients who receive thrombolytic therapy. Despite a small actual risk of transfusion-related morbidity, patients may perceive the risk associated with transfusions to be substantial. Accordingly physicians have an obligation to assuage patients' fears regarding transfusions during the process of obtaining informed consent for treatment with thrombolytic therapy. The clinical setting of acute myocardial infarction, however, makes it difficult to obtain truly informed consent that includes the risks of receiving a transfusion, as well as the risk of transfusion-related morbidity. Given this difficulty, several suggestions for physicians to enhance patient involvement in medical decision making for thrombolytic therapy are provided.
AB - With current clinical strategies for managing acute myocardial infarction, red blood cell transfusions are required to treat approximately 0.6 % to 4.0 % of patients who receive thrombolytic therapy and suffer hemorrhagic complications. The actual risk of serious subsequent morbidity (e.g., AIDS or chronic hepatitis) associated with such transfusions is small, occurring in only 0.018% to 0.12 % of patients who receive thrombolytic therapy. Despite a small actual risk of transfusion-related morbidity, patients may perceive the risk associated with transfusions to be substantial. Accordingly physicians have an obligation to assuage patients' fears regarding transfusions during the process of obtaining informed consent for treatment with thrombolytic therapy. The clinical setting of acute myocardial infarction, however, makes it difficult to obtain truly informed consent that includes the risks of receiving a transfusion, as well as the risk of transfusion-related morbidity. Given this difficulty, several suggestions for physicians to enhance patient involvement in medical decision making for thrombolytic therapy are provided.
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U2 - 10.1016/0002-8703(93)91084-R
DO - 10.1016/0002-8703(93)91084-R
M3 - Editorial
C2 - 8338034
AN - SCOPUS:0027234777
SN - 0002-8703
VL - 126
SP - 494
EP - 499
JO - American heart journal
JF - American heart journal
IS - 2
ER -