Predictors of transfusion requirements for cardiac surgical procedures at a blood conservation center

Moskowitz, David M.; Klein, James J.; Shander, Aryeh; Cousineau, Katherine M.; Goldweit, Richard S.; Bodian, Carol; Perelman, Seth I.; Kang, Hyun; Fink, Daniel A.; Rothman, Howard C.; Ergin, Mehmet

doi:10.1016/s0003-4975(03)01345-6

Cited by 111 publications

(135 citation statements)

References 30 publications

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“…In agreement with this study, we found that increased perfusion time is associated with increased risk of transfusion. However, patients with short perfusion times may be still at risk for receiving a blood transfusion [15]. Recognition of risk factors for blood transfusion may help identify patients at high risk for transfusion and facilitate decision-making to reduce perioperative blood transfusion [14].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2009

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2009

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“…4 This is a common feature of existing predictive models for blood transfusion or bleeding, all of which have been developed in single-centre cardiac surgery populations. 88,[170][171][172][173][174][175][176][177][178][179] Other limitations include heterogeneity in the definition of the reference outcome (any transfusion, red cell transfusion, bleeding), restriction to a particular type of cardiac surgery (e.g. isolated CABG [170][171][172][173] ) or small sample sizes 176,179 or presentation of regression model beta-coefficients rather than a useable risk score.…”

Section: Transfusion Risk Predictionmentioning

confidence: 99%

Diagnostic and therapeutic medical devices for safer blood management in cardiac surgery: systematic reviews, observational studies and randomised controlled trials

Murphy

Mumford

Rogers

et al. 2017

Programme Grants Appl Res

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This report should be referenced as follows:Murphy GJ, Mumford AD, Rogers CA, Wordsworth S, Stokes EA, Verheyden V, et al. Diagnostic and therapeutic medical devices for safer blood management in cardiac surgery: systematic reviews, observational studies and randomised controlled trials. Programme Grants Appl Res 2017;5(17). Programme Grants for Applied ResearchISSN 2050-4322 (Print) ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10384. The contractual start date was in July 2008. The final report began editorial review in July 2016 and was accepted for publication in April 2017. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not ...

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“…In recommending the use of multi-modality blood conservation strategies, clinical guidelines often cite studies that found such strategies to be highly efficacious in reducing exposure to allogeneic blood transfusions. 14,15 These and other similar studies, however, have important limitations -often, they are small, single-centre studies that lack proper controls or blinding -that may limit their generalizability. In the first rigorous examination of such strategies, Feagan and associates randomized 30 hospitals to implement a multi-modality blood conservation strategy or to continue with standard care (which included the use of autologous predonation in about 25% of cases) in orthopedic surgery patients.…”

Section: The Elephantsmentioning

confidence: 99%

“…Dans leurs recommandations au sujet de l'utilisation de stratégies multimodales de conservation du sang, les directives cliniques citent souvent des études qui ont démontré que de telles stratégies étaient très efficaces dans la réduction de l'exposition des patients aux transfusions de sang allogène. 14,15 Ces études -ainsi que d'autres allant dans la même direction -comportent toutefois des limitations importantes : souvent, elles sont de petite échelle et réalisées dans un seul centre, ce qui a pour résultat qu'elles manquent des contrôles et techniques en aveugle adéquats. Pour cette raison, leur potentiel de généralisation est limité.…”

Section: Les éLéphantsunclassified

Perioperative blood conservation — The experts, the elephants, the clinicians, and the gauntlet

Karkouti

McCluskey

2007

Can J Anesth/J Can Anesth

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Predictors of transfusion requirements for cardiac surgical procedures at a blood conservation center

Cited by 111 publications

References 30 publications

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

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

Diagnostic and therapeutic medical devices for safer blood management in cardiac surgery: systematic reviews, observational studies and randomised controlled trials

Perioperative blood conservation — The experts, the elephants, the clinicians, and the gauntlet

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