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

Pierre Wauthy, Charalampos Pierrakos, Louis Chebli, Redente Tortora, Pierre Wauthy, Charalampos Pierrakos, Louis Chebli, Redente Tortora

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.

Keywords: Bleeding; Blood transfusion; Cardiopulmonary bypass; Quality of life.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Brugmann University Hospital Institutional Review Board (Comité d’éthique hospitalier du Centre Hospitalier Universitaire Brugmann - OM 026) with the reference number CE 2016/23. The informed consent from each patient who agreed to participate in the study was obtained. Written informed consent was waived according to the procedure: the questionnaire was mailed to participants with an informed consent form. In case of agreement with the informed consent form, participants had to call the investigator to communicate the answers by telephone to the questions. The procedure has been validated by the ethics committee. The study is registered on Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Kaplan Meier curves in the JhW (green) group and the control group (blue): p = 0.37
Fig. 2
Fig. 2
Global, Physical, Emotional aud Social scores in the MacNEW evaluation scale

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