Analysis of the Blood Consumption for Surgical Programs

Begic, Dzenana; Mujičić, Ermina; Ćorić, Jozo; Zec, Svjetlana Loga; Žunić, Lejla

doi:10.5455/medarh.2016.70.248-251

Cited by 5 publications

(6 citation statements)

References 13 publications

(9 reference statements)

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“…4,5 Associated with reactive, infectious, and autoimmune risks, 6 BT can complicate postoperative prognoses across various surgical subspecialties and is resource-intensive. [7][8][9][10] While BT is often based on a perceived clinical need, some patient-level characteristics also contribute to increased risk of BT, including age, gender, weight, American Society of Anesthesiology (ASA) physical status, and preoperative anemia. 11,12 Evidence from studies conducted on animals undergoing thyroidectomy indicates poor survival rates among BT recipients.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, existing literature has also evaluated BT as an independent risk factor for postoperative complications 4,5 . Associated with reactive, infectious, and autoimmune risks, 6 BT can complicate postoperative prognoses across various surgical subspecialties and is resource‐intensive 7–10 . While BT is often based on a perceived clinical need, some patient‐level characteristics also contribute to increased risk of BT, including age, gender, weight, American Society of Anesthesiology (ASA) physical status, and preoperative anemia 11,12 …”

Section: Introductionmentioning

confidence: 99%

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A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients

et al. 2022

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Objectives To assess the incidence, risk factors, and complications of blood transfusions (BTs) in elective thyroidectomy patients. Methods A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program. Adult patients who underwent elective thyroidectomy from 2005 to 2019 were divided into two cohorts based on whether they received BT or not. Multivariable binary logistic regression models were used to identify risk factors of BT and its impact on postoperative complications. Results Of 180,483 patients, 0.13% received BT. Risk factors for BT included underweight body mass index (BMI) (adjusted odds ratio [OR] 3.179, 95% confidence interval [CI] 1.444–6.996), bleeding disorders (OR 2.121, 95% CI 1.149–3.913), anemia (OR 4.730, 95% CI 3.472–6.445), preoperative transfusion (OR 7.230, 95% CI 1.454–35.946), American Society of Anesthesiology physical statuses 3–5 (OR 3.103, 95% CI 2.143–4.492), operative time >150 min (OR 4.390, 95% CI 1.996–9.654), and inpatient thyroidectomy (OR 5.791, 95% CI 3.816–8.787). In addition, transfusion was independently associated with any postoperative complication, non‐infectious, cardiac, pulmonary, renal, vascular, or infectious complications, surgical site infection, sepsis, septic shock, wound disruption, pneumonia, unplanned reoperation, prolonged length of stay, and mortality. Conclusion Recognition of risk factors of BT is imperative to identify at‐risk patients and reduce transfusions by controlling modifiable risk factors such as anemia, operative time, and BMI. In cases where transfusions are still indicated, surgeons should optimize care to prevent or adequately manage transfusion‐associated complications. Level of Evidence 3 Laryngoscope, 132:2078–2084, 2022

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients

et al. 2022

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“…The average hemoglobin drop was 1.8 AE 1.8 g/dL and nine patients required periprocedural blood transfusions which was consistent with the type of surgery performed, known to need a larger spending of blood products, as orthopaedic, general, and cardiac surgery. 27 One-third of patients experienced periprocedural BARC 3/GUSTO moderate bleeding events due to drainages output, but a hemoglobin drop !3 g/dL was observed in only three cases. No fatal, life-threatening, or intracranial bleedings occurred.…”

Section: Discussionmentioning

confidence: 99%

Antiplatelet Therapy with Cangrelor in Patients Undergoing Surgery after Coronary Stent Implantation: A Real-World Bridging Protocol Experience

Rossini

Masiero

Fruttero

et al. 2020

TH Open

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Objective The aim of the study is to describe the real-world use of the P2Y12 inhibitor cangrelor as a bridging strategy in patients at high thrombotic risk after percutaneous coronary intervention (PCI) and referred to surgery requiring perioperative withdrawal of dual antiplatelet therapy (DAPT). Materials and Methods We collected data from nine Italian centers on patients with previous PCI who were still on DAPT and undergoing nondeferrable surgery requiring DAPT discontinuation. A perioperative standardized bridging protocol with cangrelor was used. Results Between December 2017 and April 2019, 24 patients (mean age 72 years; male 79%) were enrolled. All patients were at high thrombotic risk after PCI and required nondeferrable intermediate to high bleeding risk surgery requiring DAPT discontinuation (4.6 ± 1.7 days). Cangrelor infusion was started at a bridging dose (0.75 µg/kg/min) 3 days before planned surgery and was discontinued 6.6 ± 1.5 hours prior to surgical incision. In 55% of patients, cangrelor was resumed at 9 ± 6 hours following surgery for a mean of 39 ± 38 hours. One cardiac death was reported after 3 hours of cangrelor discontinuation prior to surgery. No ischemic outcomes occurred after surgery and up to 30-days follow-up. The mean hemoglobin drop was <2 g/dL; nine patients received blood transfusions consistent with the type of surgery, but no life-threatening or fatal bleeding occurred. Conclusion Perioperative bridging therapy with cangrelor is a feasible approach for stented patients at high thrombotic risk and referred to surgery requiring DAPT discontinuation. Larger studies are warranted to support the safety of this strategy.

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“…( 24 ). Large ordering of blood should be minimized by changing the ordering of blood through the form of maximum surgical blood ordering ( 23 - 26 , 27 ). Proper placement of requests for blood, according to the designed schedule is intended with capricious ordering blood MSBOS used to promote the automatic limiting the application of the blood, and thus leads to an increase in the effective ordering of blood.…”

Section: Discussionmentioning

confidence: 99%

“…MSBOS for the planned surgeries, enables more efficient management of available reserves of blood by the oldest composition of blood, the first issue to use for waste reduction levels, then reduce the number of unnecessary lab testing, reducing the overall cost of the health institution (due to more efficient use of human and material resources in blood transfusion service) and all without compromising patient safety. MSBOS has long been applied in all developed countries in the world ( 24 - 26 , 27 ). The use of blood for surgical programs supplemented and/or corrected in accordance with their own experience/practice of using blood preparations ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

The Management of Transfusion Services, Analysis and Assessment

Begic¹,

Mujičić²,

Ćorić³

et al. 2016

Mater Sociomed

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Introduction:The hospital blood bank (HBB) need to timely provide adequate amounts of blood and blood products for surgeries. For various surgical programs are performed assessments of the average number of blood doses needed for surgery. By using two types of requisitions BT/AB (blood type/antibody) and BT/AB/MT (blood type/antibody/match test) for pretransfusion immunohaematological testing in General Hospital “Prim. Dr. Abdulah Nakas” is achieved more rational consumption of blood and blood derivatives and financial savings through reduced number of matching tests (MT).Goal:To determine the total amount of pre-operative requisitions (BT/AB and BT/AB/MT) for blood and blood products at surgical departments of the General Hospital “Prim. Dr. Abdulah Nakas” in the period from June 1, 2014 – December 31, 2014 and analyze the consumption/return of blood in reserve in relation to the surgical disciplines, the total number of savings in MT. Conduct assessments MSBOS (Maximum Surgical Blood Ordering Schedule).Results:The total amount of preoperative requisitions for blood and blood products in surgical wards was 927 requests from which 623 demands or 67.2% is tested by BT/MT, while 304 or 32.8% was tested by BT/AB/MT. Transfused in total was 617 units of blood and blood products, 275 units were not transfused. Probability of transfusions for surgery was 51.3, the highest in the case of surgical intensive care 70.4 and the lowest for the department of general surgery 37.2%. Assessment of indicators of efficient resource management indicates they are the best at the delivery ward 0.89, while a total for surgical wards is 0.69. In total for surgery on the average were required 2.1 units of blood. By using two types of requisitions for pretransfusion immunohaematological testing (BT/AB and CG/AB/MT) is achieved more rational use of MT. In 623 requests for BT/AB only 61 MT were performed. Average of blood units issued in accordance with these requirements is 0.08 and the savings in the number of MT amounts to 562.

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Analysis of the Blood Consumption for Surgical Programs

Cited by 5 publications

References 13 publications

A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients

A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients

Antiplatelet Therapy with Cangrelor in Patients Undergoing Surgery after Coronary Stent Implantation: A Real-World Bridging Protocol Experience

The Management of Transfusion Services, Analysis and Assessment

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