To describe the safety and feasibility of urological transfusion-free surgeries in Jehovah's Witness patients. Methods: An institutional review board-approved, retrospective review of Jehovah's Witness patients who underwent urological transfusion-free surgeries between 2003 and 2019 was carried out. Surgeries were stratified into low, intermediate and high risk based on complexity, invasiveness and bleeding potential. Patient demographics, perioperative data and clinical outcomes are reported. Results: A total of 161 Jehovah's Witness patients (median age 63.4 years) underwent 171 transfusion-free surgeries, including 57 (33.3%) in low-, 82 (47.9%) in intermediateand 32 (18.8%) in high-risk categories. The mean estimated blood loss increased with risk category at 48 mL (range 10-50 mL), 150 mL (range 50-200 mL) and 388 mL (range 137-500 mL), respectively (P < 0.001). Implementing blood augmentation and conservation techniques increased with each risk category (3.5% vs 29% vs 69%, respectively; P < 0.001). Average length of stay increased concordantly at 1.6 days (range 0-12 days), 2.9 days (range 1-13 days) and 5.6 days (range 2-12 days), respectively (P ≤ 0.001). However, there was no increase in complication rates and readmission rates attributed to bleeding among the risk categories at 30 days (P = 0.9 and 0.4, respectively) and 90 days (P = 0.7 and 0.7, respectively). Conclusions: Transfusion free urological surgery can be safely carried out on Jehovah's Witness patients using contemporary perioperative optimization. Additionally, these techniques can be expanded for use in the general patient population to avoid short-and long-term consequences of perioperative blood transfusion.
patients in rural and low HI areas. Using these data, we created a living database to help clinicians direct patients to pharmacies where prescriptions can be filled promptly. Understanding barriers to medication acquisition helps providers advocate for patients with potential challenges in care.
fitting prediction model with seven significant factors was developed. The C-index and two Hosmer-Lemeshow type statistics of the prediction model were 0.785 (95% CI, 0.755-0.815), 4.810 (p [ 0.8506), and 5.285 (p [ 0.8088). The optimism-corrected estimate through the internal validation was 0.774 (95% CI, 0.744-0.804) and the optimism-corrected calibration curve was close to the ideal line with mean absolute error [ 0.012. In external validation, the discrimination was 0.657 (95% CI, 0.560-0.755) and two calibration statistics were 0.790 (p [ 0.9397) and 3.103 (p [ 0.5408), respectively.CONCLUSIONS: A validated prediction model based on a large Korean RNU cohort was developed with acceptable performance to estimate DFS in patients with UTUC.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.