Beware of heterogeneity when assessing the bleeding risk using multi‐specialty and multi‐year database.

Restrictive transfusion strategies and antifibrinolytic therapy as part of patient blood management contributed to the recent transfusion practice changes.[5] Therefore, performing a subgroup analysis with year as a covariate would be insightful in future studies. Keywords: bleeding; blood transfusion; coagulation testing; surgery EN bleeding blood transfusion coagulation testing surgery 893 894 2 04/13/23 20230401 NES 230401 We read with great interest a recently published work by Lim and colleagues. on the association between preoperative coagulation tests and perioperative red blood cell (RBC) transfusion.[1] This retrospective analysis included 672,075 elective major surgical cases that occurred between 2004 and 2018 using the National Surgical Quality Improvement Program (NSQIP) database. For example, colectomy patients represented the majority of their general surgery codes, but transfusion rates substantially varied between laparoscopic and open colectomies for partial (4.1% vs. 9.4%) and total resection (15.2% vs. 29.6%) (Table 1). [Extracted from the article]