This large observational study shows that institutional variability in current transfusion practices for commonly performed major noncardiac surgical procedures remains troublingly high. This is not the first study of its kind, and it suffers some limitations. However, it included a huge number of hospitals and cases (more than 54,000 primary total hip replacement procedures in 77 hospitals) over the past few years and an adjustment for patient risk factors was performed. As the authors speculate, the observed variability reflects uncertainty on how to best balance the benefits and risks of blood transfusion in surgical patients.
– Yves Ozier