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

Blood transfusions are rare during elective thoracic surgery, yet routine ordering of preoperative type and screens (pre-T&S) is common. In this context, an international survey was conducted to assess thoracic surgeons' practice patterns.

A 42-question, internet-based survey was sent to all thoracic surgeons registered in CTSNet. Responses were collected from April to July, 2023. We collected data on surgeon demographics, description of clinical practice, preoperative routines, and their approach to hypothetical clinical vignettes. These sections were compared between surgeons who routinely order a pre-T&S and those who do not by using the Pearson χ ² test for categorical variables, and the Student t test or Mann-Whitney U test for continuous variables.

Surveys were sent to 2499 thoracic surgeons, 173 of whom filled out the survey; 129 (74.6%) surveys were fully completed. Most respondents were male (88.4%), with a mean age of 52.6 (SD 9.5) years (n = 127) and an average of 18.4 (9.5) years in practice. Most were from North America (54.0%). A total of 78.8% of surgeons routinely order a pre-T&S; however, the average estimated bleeding incidence was 4.0%, with an intraoperative transfusion rate of 2.0%. Despite routine pre-T&S ordering, 57.5% of surgeons were willing to use a decision aid tool, if available. Surgeons reported that institutional policy affected their practice.

Largely because of institutional policy, most surgeons worldwide still order a routine pre-T&S despite acknowledging a low bleeding risk and the rarity of intraoperative transfusions. Most surgeons are open to changing this practice.