A model for predicting transfusion after coronary artery bypass grafting

Magovern, James A.; Sakert, Tamara; Benckart, Daniel H.; Burkholder, John A.; Liebler, George A.; Magovern, George J.

doi:10.1016/0003-4975(95)00808-x

Cited by 140 publications

(140 citation statements)

References 13 publications

Supporting

Mentioning

127

Contrasting

Unclassified

Order By: Relevance

“…This is consistent with several previous studies in which demographic details, comorbidities, conventional pre‐operative laboratory test results31, 32, 33, 34, 35, and procedural characteristics31, 35 contributed to prediction of RBC transfusion. The baseline‐only model confirmed that exposure to anti‐platelet drugs before cardiac surgery is also a strong predictor of post‐operative bleeding 17, 20.…”

Section: Discussionsupporting

confidence: 92%

Near‐patient coagulation testing to predict bleeding after cardiac surgery: a cohort study

Mumford

Harris

Plummer

et al. 2017

Research and Practice in Thrombosis and Haemostasis

View full text Add to dashboard Cite

Essentials Near‐patient testing improves coagulopathy diagnosis in cardiac surgery patients with severe bleeding.We investigated how well pre‐emptive near‐patient testing predicted severe bleeding.Severe bleeding could be predicted using both near‐patient tests and patient clinical characteristics.Near‐patient test results gave little additional predictive value over clinical characteristics alone. BackgroundCoagulopathic bleeding is common after cardiac surgery and is associated with increased morbidity, mortality and healthcare costs. Implementation of blood management algorithms in which patients with severe bleeding undergo near‐patient coagulation testing results in less overall bleeding and transfusion. However, it is unknown whether there is additional value from pre‐emptive near‐patient testing to predict whether severe bleeding will occur.ObjectivesTo evaluate how well a comprehensive panel of 28 near‐patient platelet and viscoelastometry tests predict bleeding after cardiac surgery, compared to prediction using baseline clinical characteristics alone.MethodsSingle‐center, prospective cohort study in adults undergoing a range of cardiac surgery procedures. The primary outcome was clinical concern about bleeding (CCB), a composite of high blood loss (chest drain volume >600 mL within 6 hours), re‐operation for bleeding or administration of a pro‐haemostatic treatment directed by clinician judgement.ResultsIn 1833 patients recruited between March 2010 and August 2012, the median number of abnormal near‐patient test results was 5/28 per patient (range 0‐18). CCB occurred in 449/1833 patients (24.5%). The c‐statistic for a predictive model for CCB using only baseline clinical characteristics (baseline‐only model) was 0.72 (95% CI 0.69‐0.75). Addition of near‐patient test results to this model (baseline‐plus‐test model) improved the prediction of CCB (c‐statistic 0.75 [0.72‐0.77]), but increased the number of correctly classified patients by only 18 (0.98%).ConclusionsNear‐patient coagulation testing predicts bleeding in cardiac surgery patients, but offers little improvement in prediction compared to baseline clinical characteristics alone. trial registration: ISRNCTN 20778544 (http://www.isrctn.com/).

show abstract

Section: Discussionsupporting

confidence: 92%

Near‐patient coagulation testing to predict bleeding after cardiac surgery: a cohort study

Mumford

Harris

Plummer

et al. 2017

Research and Practice in Thrombosis and Haemostasis

View full text Add to dashboard Cite

show abstract

“…In our study, we determined some of these risk factors (Table 3). Magovern et al in their study revealed the perfusion time as independent predictor of blood transfusion [14]. In agreement with this study, we found that increased perfusion time is associated with increased risk of transfusion.…”

Section: Discussionsupporting

confidence: 93%

Transfusion associated in-hospital mortality and morbidity in isolated Coronary Artery Bypass Graft surgery

et al. 2009

View full text Add to dashboard Cite

AbstractTransfusion after cardiac surgery is very common. This rate varies between institutions and has remained high despite established transfusion guidelines. We analyzed our database of patients who underwent isolated CABG (Coronary Artery Bypass Graft) to determine the predictive factors of homologous transfusion and associated postoperative morbidity, mortality and resource utilization. All 14,152 patients who underwent first-time isolated CABG, with or without cardiopulmonary bypass (CPB) who had postoperative homologous transfusion between February 2002 and March 2008 in Tehran Heart Center, were evaluated retrospectively. Overall, 16.5% of patients received transfusion. Transfused patients demonstrated a significantly higher incidence of postoperative complications (cardiac, infectious, ischemic, reoperation) and mortality (p<0.001). Homologous blood transfusion effect on mortality, morbidity and resource utilization. By Multivariable logistic regression analysis adjusted for confounders: Homologous blood transfusion effect on Mortality (30-days) (OR=3.976, p<0.0001), Prolonged ventilation hours (OR=4.755, p<0.0001), Total ICU hours (β =14.599, p<0.0001), Hospital length of stay (β =1.141, p<0.0001), Post surgery length of stay (β =0.955, p<0.0001). We conclude that the isolated CABG patients receiving blood transfusion have significantly higher mortality, morbidity and resource utilization. Homologous blood transfusion is an independent factor of increased resource utilization, morbidity and mortality.

show abstract

“…Approximately one-third of the operated patients require blood transfusion, being responsible for the consumption of 10% to 25% of the hemoderivatives in the United States [10][11][12][13].…”

mentioning

confidence: 99%

O impacto da hemotransfusão na morbimortalidade pós-operatória de cirurgias cardíacas

Dorneles¹,

Bodanese²,

Guaragna³

et al. 2011

Rev Bras Cir Cardiovasc

View full text Add to dashboard Cite

A model for predicting transfusion after coronary artery bypass grafting

Cited by 140 publications

References 13 publications

Near‐patient coagulation testing to predict bleeding after cardiac surgery: a cohort study

Near‐patient coagulation testing to predict bleeding after cardiac surgery: a cohort study

Transfusion associated in-hospital mortality and morbidity in isolated Coronary Artery Bypass Graft surgery

O impacto da hemotransfusão na morbimortalidade pós-operatória de cirurgias cardíacas

Contact Info

Product

Resources

About