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Perioperative, transfusion, mortality

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https://www.readbyqxmd.com/read/28299184/revisiting-blood-transfusion-and-predictors-of-outcome-in-cardiac-surgery-patients-a-concise-perspective
#1
REVIEW
Carlos E Arias-Morales, Nicoleta Stoicea, Alicia A Gonzalez-Zacarias, Diana Slawski, Sujatha P Bhandary, Theodosios Saranteas, Eva Kaminiotis, Thomas J Papadimos
In the United States, cardiac surgery-related blood transfusion rates reached new highs in 2010, with 34% of patients receiving blood products. Patients undergoing both complex (coronary artery bypass grafting [CABG] plus valve repair or replacement) and non-complex (isolated CABG) cardiac surgeries are likely to have comorbidities such as anemia. Furthermore, the majority of patients undergoing isolated CABG have a history of myocardial infarction. These characteristics may increase the risk of complications and blood transfusion requirement...
2017: F1000Research
https://www.readbyqxmd.com/read/28296737/incidence-influencing-factors-and-prognostic-impact-of-intraoperative-massive-blood-loss-in-adolescents-with-neuromuscular-scoliosis-a-strobe-compliant-retrospective-observational-analysis
#2
Rui Jia, Na Li, Bi-Yun Xu, Wei Zhang, Xiao-Ping Gu, Zheng-Liang Ma
Factors influencing massive blood loss for neuromuscular scoliosis (NMS) patients.Despite advances in surgical and anesthetic techniques, scoliosis surgery is still associated with intraoperative massive blood loss, which can result in postoperative mortality and morbidity. The aim of this study was to assess the incidence, influencing factors, and prognostic impact of intraoperative massive blood loss in adolescents with NMS.A retrospective review of adolescents who underwent posterior spinal instrumentation and fusion for NMS was performed...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28260994/risk-factors-for-intraoperative-massive-transfusion-in-pediatric-liver-transplantation-a-multivariate-analysis
#3
Seok-Joon Jin, Sun-Key Kim, Seong-Soo Choi, Keum Nae Kang, Chang Joon Rhyu, Shin Hwang, Sung-Gyu Lee, Jung-Man Namgoong, Young-Kug Kim
Background: Pediatric liver transplantation (LT) is strongly associated with increased intraoperative blood transfusion requirement and postoperative morbidity and mortality. In the present study, we aimed to assess the risk factors associated with massive transfusion in pediatric LT, and examined the effect of massive transfusion on the postoperative outcomes. Methods: We enrolled pediatric patients who underwent LT between December 1994 and June 2015. Massive transfusion was defined as the administration of red blood cells ≥100% of the total blood volume during LT...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28259576/female-sex-independently-predicts-mortality-after-thoracic-endovascular-aortic-repair-for-intact-descending-thoracic-aortic-aneurysms
#4
Sarah E Deery, Katie E Shean, Grace J Wang, James H Black, Gilbert R Upchurch, Kristina A Giles, Virendra I Patel, Marc L Schermerhorn
OBJECTIVE: Whereas sex differences in the pathogenesis, presentation, and outcomes of repair for abdominal aortic aneurysms are well studied, less is known about sex differences after thoracic endovascular aortic repair (TEVAR). The goal of this study was to evaluate the association between sex and morbidity and mortality after TEVAR. METHODS: A retrospective review of all TEVARs in the Society for Vascular Surgery Vascular Quality Initiative (VQI) registry from 2011 to 2015 was conducted, excluding those with dissection, trauma, and rupture...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259203/perioperative-blood-transfusions-increases-the-risk-of-anastomotic-leakage-after-surgery-for-gej-cancer
#5
Kaare Terp Fjederholt, Lars Bo Svendsen, Frank Viborg Mortensen
OBJECTIVE: To investigate the effect of blood transfusions on the risk of anastomotic leakage (AL) in patients with gastro-esophageal-junction (GEJ) cancer. BACKGROUND: The incidence of GEJ cancer is increasing in the western world. Surgery is the curative treatment of choice. AL increases mortality and morbidity, and increases the risk cancer reoccurrence. In colo-rectal surgery a relation between AL and blood transfusions have been demonstrated. METHOD: The risk of AL in relation to blood transfusions was investigated in a cohort study...
February 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28254607/laparoscopic-left-sided-hepatectomy-for-the-treatment-of-hepatolithiasis-a-comparative-study-with-open-approach
#6
Long Peng, Jian Xiao, Zhanying Liu, Jisheng Zhu, Renhua Wan, Weidong Xiao, Yong Li
BACKGROUND: Hepatolithiasis is a prevalent disease in some regions of China. Left-sided hepatectomy is an effective treatment for left intrahepatic bile duct stones with irreversible disease, such as biliary strictures, severe parenchymal fibrosis or atrophy. However, the advantages of laparoscopic left-sided hepatectomy (LLH) over open approach (OLH) are still controversial. The aim of this study was to compare the clinical outcomes of LLH to those of OLH in the treatment of hepatolithiasis...
February 28, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28253573/-clinical-comparative-analysis-of-comprehensive-laparoscopic-and-laparotomic-staging-of-early-stage-epithelial-ovarian-cancer
#7
W Xiong, L L Cao, L P Jiang, H Xia, Z Q Liang
Objective: To investigate the value of laparoscopy in comprehensive early ovarian cancer staging by comparing the feasibility and safety of laparoscopy and laparotomy in surgical staging of early-stage epithelial ovarian cancer (EOC). Methods: A total of 102 patients with EOC who underwent comprehensive laparoscopic (LPS group, n=71) or laparotomic (LPT group, n=31) staging at Southwest Hospital from November 2007 to November 2014 were retrospectively analyzed. The perioperative parameters, postoperative complication rate and the long-term curative effect were compared between the two groups...
February 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28225801/perioperative-hemoglobin-area-under-the-curve-is-an-independent-predictor-of-renal-failure-after-cardiac-surgery-results-from-a-spanish-multicenter-retrospective-cohort-study
#8
Paula Duque-Sosa, Diego Martínez-Urbistondo, Gemma Echarri, Raquel Callejas, María Josefa Iribarren, Gregorio Rábago, Pablo Monedero
Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introduces the concept of perioperative hemoglobin area under the curve (pHb-AUC) as a surrogate marker of the evolution of perioperative hemoglobin concentration. Through a retrospective analysis of prospectively collected data, we assessed this new variable as a risk factor for the development of acute kidney injury after cardiac surgery in 966 adult patients who underwent cardiac surgery with cardiopulmonary bypass, at twenty-three academic hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28222991/perioperative-clopidogrel-is-associated-with-increased-bleeding-and-blood-transfusion-at-the-time-of-lower-extremity-bypass
#9
Douglas W Jones, Marc L Schermerhorn, Benjamin S Brooke, Mark F Conrad, Philip P Goodney, Mark C Wyers, David H Stone
OBJECTIVE: Controversy persists surrounding the perceived bleeding risk associated with perioperative clopidogrel use in patients undergoing lower extremity bypass (LEB). The purpose of this study was to examine the LEB bleeding risk and clinical sequelae associated with clopidogrel. METHODS: All LEBs in the Vascular Quality Initiative (VQI) from 2008 to 2014 were studied. The exposure was perioperative clopidogrel. Primary outcomes were blood transfusion, estimated blood loss ≥500 mL, and reoperation for bleeding...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28219665/comparison-of-hospital-outcome-of-transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-diabetes-mellitus-from-the-nationwide-inpatient-sample
#10
Tomo Ando, Emmanuel Akintoye, Tesfaye Telila, Alexandros Briasoulis, Hisato Takagi, David P Slovut, Theodore Schreiber, Cindy L Grines, Luis Afonso
The comparative outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in diabetes mellitus (DM) patients are scarce. We aimed to assess and compare the outcomes of TAVR versus SAVR in DM patients using the Nationwide Inpatient Sample database from 2011 to 2013. A complete case analysis was performed for the multivariate analysis and cases with missing data were excluded. The primary end point was in-patient all-cause mortality and secondary outcomes were perioperative complications...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28216366/implications-of-concomitant-hypogastric-artery-embolization-with-endovascular-repair-of-infrarenal-abdominal-aortic-aneurysms
#11
Behzad S Farivar, Richa Kalsi, Charles B Drucker, Carly B Goldstein, Rajabrata Sarkar, Shahab Toursavadkohi
OBJECTIVE: Hypogastric artery embolization (HAE) is associated with significant risk of ischemic complications. We assessed the impact of HAE on 30-day outcomes of endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysms. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2014 to identify and to compare clinical features, operative details, and 30-day outcomes of EVAR with those of concomitant HAE with EVAR (HAE + EVAR)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216362/endovascular-aneurysm-repair-patients-who-are-lost-to-follow-up-have-worse-outcomes
#12
Caitlin W Hicks, Devin S Zarkowsky, Ian C Bostock, David H Stone, James H Black, Jens Eldrup-Jorgensen, Philip P Goodney, Mahmoud B Malas
BACKGROUND: Society for Vascular Surgery practice guidelines recommend 1- and 12-month follow-up with computed tomography imaging for the year after endovascular aneurysm repair (EVAR). We describe the incidence, risk factors, and outcomes of EVAR patients who are lost to follow-up (LTF). METHODS: All patients undergoing elective EVAR in the Vascular Quality Initiative (VQI) data set (January 2003-December 2015) were stratified according to long-term follow-up method (in-person vs phone call vs LTF)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28203019/-investigation-of-risk-factors-of-acute-kidney-injury-after-off-pump-coronary-artery-bypass-grafting-and-3-years-follow-up
#13
X H Li, F Xiao, S Y Zhang
OBJECTIVE: To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up. METHODS: In the study, 299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included. The patients were divided into AKI group with AKI and control group without AKI after operation...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28194489/the-effect-of-preoperative-anemia-on-the-outcome-after-coronary-surgery
#14
Tuomas Tauriainen, Joni Koski-Vähälä, Eeva-Maija Kinnunen, Fausto Biancari
BACKGROUND: Preoperative anemia is associated with increased morbidity and mortality after cardiac surgery. Since anemia is ultimately treated with red blood cell transfusions, we investigated the independent impact of anemia and transfusion on the outcome after coronary artery bypass grafting (CABG). METHODS: This study included 2761 consecutive patients who underwent isolated CABG. Anemia was defined as hemoglobin <12.0 g/dL in women and <13.0 g/dL in men...
February 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28161216/the-impact-of-perioperative-red-blood-cell-transfusions-in-patients-undergoing-liver-resection-a-systematic-review
#15
REVIEW
Sean Bennett, Laura K Baker, Guillaume Martel, Risa Shorr, Timothy M Pawlik, Alan Tinmouth, Daniel I McIsaac, Paul C Hébert, Paul J Karanicolas, Lauralyn McIntyre, Alexis F Turgeon, Jeffrey Barkun, Dean Fergusson
BACKGROUND: Liver resection is associated with a high proportion of red blood cell transfusions. There is a proposed association between perioperative transfusions and increased risk of complications and tumor recurrence. This study reviews the evidence of this association in the literature. METHODS: The Medline, EMBASE, and Cochrane databases were searched for clinical trials or observational studies of patients undergoing liver resection that compared patients who did and did not receive a perioperative red blood cell transfusion...
February 1, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28154997/risk-associated-with-perioperative-red-blood-cell-transfusion-in-cranial-surgery
#16
Jonathan A Cohen, Nima Alan, Andreea Seicean, Robert J Weil
We assessed the impact of intra- and postoperative RBC transfusion on postoperative morbidity and mortality in cranial surgery. A total of 8924 adult patients who underwent cranial surgery were identified in the 2006-2011 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. Patients undergoing a biopsy, radiosurgery, or outpatient surgery were excluded. Propensity scores were calculated according to demographic variables, comorbidities, and preoperative laboratory values...
February 3, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28154270/reassessment-of-acute-kidney-injury-after-cardiac-surgery-a-retrospective-study
#17
Xiangcheng Xie, Xin Wan, Xiaobing Ji, Xin Chen, Jian Liu, Wen Chen, Changchun Cao
Objective To evaluate the incidence, risk, or protective factors of acute kidney injury (AKI) in patients after cardiac surgery based on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Methods A retrospective analysis of 2,575 patients undergoing their first documented cardiac surgery with cardiopulmonary bypass (CPB) was conducted. Perioperative variables were collected and analyzed. Univariate and multiple logistic regression models were used for determining the association between the development of AKI and risk factors...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28131428/a-new-intraoperative-protocol-for-reducing%C3%A2-perioperative-transfusions-in%C3%A2-cardiac-surgery
#18
J Hunter Mehaffey, Sarah A Schubert, Michael G Gelvin, Eric J Charles, Robert B Hawkins, Lily E Johnston, Gorav Ailawadi, Irving L Kron, Leora T Yarboro
BACKGROUND: Perioperative anemia and blood product transfusion increases short-term and long-term morbidity and mortality during cardiac surgery. We hypothesized that streamlined cardiopulmonary bypass circuit and rotational thromboelastometry (ROTEM) would reduce blood product usage and improve outcomes. METHODS: All patients with Society of Thoracic Surgeons risk scores at our institution from January 2013 to June 2015 were included. Individuals were chronologically stratified into 2 groups according to institutional changes to a streamlined bypass circuit and ROTEM-guided transfusion...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28122491/mild-volume-acute-normovolemic-hemodilution-is-associated-with-lower-intraoperative-transfusion-and-postoperative-pulmonary-infection-in-patients-undergoing-cardiac-surgery-a-retrospective-propensity-matching-study
#19
Zhen-Feng Zhou, Xiu-Ping Jia, Kai Sun, Feng-Jiang Zhang, Li-Na Yu, Tian Xing, Min Yan
BACKGROUND: Perioperative allogenic transfusion is required in almost 50% of patients undergoing cardiac surgery and is associated with higher risk of mortality and morbidity (Xue et al., Lancet 387:1905, 2016; Ferraris et al., Ann Thorac Surg 91:944-82, 2011). Acute normovolemic hemodilution (ANH) is recommended as a potential strategy during cardiac surgery, but the blood conservation effect and the degree of ANH was still controversial. There is also an increasing concern about the improved outcomes associated with ANH...
January 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28109762/higher-modified-charlson-index-scores-are-associated-with-increased-incidence-of-complications-transfusion-events-and-length-of-stay-following-revision-hip-arthroplasty
#20
Nikita Lakomkin, Vadim Goz, Claudette M Lajam, Richard Iorio, Joseph A Bosco
BACKGROUND: Revision total hip arthroplasty (RHA) has been associated with greater morbidity and length of stay (LOS) compared to primary total hip arthroplasty. Despite this, few validated metrics exist for risk stratification in RHA cohorts. The Charlson Comorbidity Index (CCI) has been associated with complications in total hip arthroplasty, but its utility in revision surgery remains unexplored. The purpose of this study was to examine the relationship between preoperative CCI and a variety of outcome metrics following RHA...
November 17, 2016: Journal of Arthroplasty
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