Thoracic Surgeons' Practice Patterns and Attitudes Toward Preoperative Testing for Blood Resource Use: An...

Area of Science:

• Cardiothoracic Surgery
• Transfusion Medicine
• Surgical Practice Patterns

Background:

• Blood transfusions are infrequently required during elective thoracic surgery.
• Routine preoperative type and screens (pre-T&S) are common despite the low incidence of transfusions.
• This practice pattern warrants investigation among thoracic surgeons globally.

Purpose of the Study:

• To assess the current practice patterns of thoracic surgeons regarding preoperative type and screens (pre-T&S).
• To identify factors influencing the routine ordering of pre-T&S in elective thoracic surgery.
• To gauge surgeon openness to alternative strategies for preoperative testing.

Main Methods:

• An international, internet-based survey was distributed to thoracic surgeons via CTSNet.
• The survey included 42 questions covering demographics, clinical practice, preoperative routines, and hypothetical scenarios.
• Statistical comparisons (Pearson chi-squared, Student t-test, Mann-Whitney U) were used to analyze differences between groups.

Main Results:

• A high percentage of surgeons (78.8%) routinely order pre-T&S, despite acknowledging low bleeding risks (4.0%) and transfusion rates (2.0%).
• Institutional policy was identified as a significant factor influencing surgeons' ordering habits.
• A majority of respondents (57.5%) expressed willingness to adopt decision aid tools to guide preoperative testing.

Conclusions:

• Most thoracic surgeons worldwide continue routine pre-T&S orders, largely due to institutional policies, not clinical necessity.
• There is a recognized low risk of bleeding and rare need for intraoperative transfusions in elective thoracic surgery.
• Surgeons are receptive to practice changes and decision support tools, indicating potential for optimizing preoperative testing protocols.