Having surgery? Four questions to ask

Patients are encouraged to ask their doctor about blood transfusions, a common procedure during surgery

surgeryblogimage.fwBefore surgery, patients often have a long list of questions such as what type of anesthesia will be used, what the risks are and what recovery will be like.

A less common subject that we encourage people to discuss with their physicians is blood transfusions.

Often used for anemia or during surgery to make up for blood loss, transfusions are one of the most common procedures patients receive in the hospital. However, our recent analysis found that the more red blood cell transfusions you receive, the greater your risk of an infection such as pneumonia.

A nationwide effort called the “Choosing Wisely” campaign recommends that patients planning for surgery or a hospital admission discuss transfusions and other common medical procedures with their physician ahead of time.

Questions I suggest patients ask before surgery or being admitted to the hospital:

  • As a patient, what can I do before hospitalization to prevent or decrease my likelihood of developing anemia?
  • What are ways that blood loss can be minimized when I am hospitalized?  Would any of these options be available for me?
  • What are the criteria that the hospital uses to decide whether or not I would need a blood transfusion?
  • Would you please keep me and my family informed during the hospitalization regarding these options, the number and types of transfusions that I was given, and let me know whether there is anything I can do to help?

The risk of infection is likely due to the patient’s immune system reacting to donor blood. Our analysis found that elderly patients undergoing hip or knee surgeries, in particular, were at higher risk of infection.

Transfusions may benefit patients with severe anemia or blood loss; however, for others, the risks may outweigh the benefits. Only 31 percent of hospitals report having a blood management program that aims to optimize the care of patients who might need a transfusion so it’s important you discuss these issues with your doctor ahead of time.

Your diet, the medications that you are now taking, and your current medical conditions such as kidney disease, may influence your likelihood of developing anemia and whether you will need a transfusion.  Discuss these factors with your doctor so you can work together before, during and after your hospitalization.

Take the next step:

mary_rogersBlogMary A.M. Rogers, Ph.D., M.S., is a research associate professor in internal medicine at the University of Michigan Medical School and research director of the Patient Safety Enhancement Program at the U-M Health System and the VA Ann Arbor Healthcare System.  She is also a member of U-M’s Institute for Healthcare Policy and Innovation.



IHPI-LogoSmall.fwFounded in 2011, the U-M Institute for Healthcare Policy & Innovation includes more than 400 health services researchers from across the University of Michigan and several nonprofit and private sector partners. IHPI’s members form one of the nation’s largest communities of physicians, health scientists and policy analysts dedicated to studying how health care works and how it can be improved.