Correspondence Address:
Bharathi H Scott
Department of Anesthesiology, SUNY at Stony Brook Health Sciences Center, L4-060, Stony Brook, NY 11794-8480
USA

Full Text

The Editor,

We would like to thank the authors [1] for their interest and comments regarding our article entitled "Blood transfusion is associated with increased resource utilisation, morbidity and mortality in cardiac surgery?" [2] We agree with Dr. Kapoor. [1] that the data confirms that "perioperative factors are predictors of blood usage and that the requirement of blood transfusion is associated with increased resource utilisation and postoperative morbidity." The goal of our investigation was to examine the impact of transfusion on resource utilisation, morbidity, mortality, and postoperative length of stay. But we disagree with their following sentence, which states that transfusion is consequent to these associated factors and thus can't be an independent predictor of increased utilisation and postoperative morbidity.

Our definition of independent predictor is not unusual and is given near the end of our "Discussion" section: "Our analysis shows that transfusion is an independent predictor of increased utilisation because even in patients with no preoperative morbidities, transfusion correlated with increased duration of intubation, ICULOS and PLOS." The particulars are given in the "Results" section.

In other words, if transfusion at the time of surgery is required, then independent of other factors, increased utilisation is a likely occurrence; transfusion independently was responsible for increased resource utilisation.

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