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Perioperative anemia

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https://www.readbyqxmd.com/read/29773300/neoadjuvant-chemotherapy-is-associated-with-more-anemia-and-perioperative-blood-transfusions-than-primary-debulking-surgery-in-women-with-advanced-stage-ovarian-cancer
#1
Andrea O'Shea, Kevin McCool, Ross Harrison, Emmanuel Sampene, Joseph Connor, Lisa Barroilhet
OBJECTIVE: The purpose of this case-controlled study was to determine the prevalence of anemia and incidence of perioperative blood transfusions in patients undergoing treatment for advanced ovarian cancer with neoadjuvant chemotherapy (NACT) or primary debulking surgery (PDS). METHODS: We performed a single institution review of patients diagnosed with stage IIIB-IVB epithelial ovarian cancer between 2010 and 2013 undergoing either NACT or PDS. Anemia was defined as a hemoglobin (Hgb) concentration of ≤11...
May 15, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29732419/complications-following-single-level-interbody-fusion-procedures-an-acs-nsqip-study
#2
Jamal N Shillingford, Joseph L Laratta, Joseph M Lombardi, John D Mueller, Meghan Cerpa, Hemant P Reddy, Comron Saifi, Charla R Fischer, Ronald A Lehman
Background: Controversy exists over the ability of various lumbar interbody fusion techniques to realign global and regional balance and their effect on patient outcomes. This is a retrospective cohort study to compare thirty-day postoperative outcomes between anterior and posterior interbody fusion techniques within a large national database. Methods: A retrospective cohort study utilizing the National Surgical Quality Improvement Program (NSQIP) database included 2,372 (29...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29731670/assessing-the-costs-and-benefits-of-perioperative-iron-deficiency-anemia-management-with-ferric-carboxymaltose-in-germany
#3
Bernd Froessler, Alexandra M Rueger, Mark P Connolly
Background: Perioperative administration of ferric carboxymaltose (FCM) was previously shown to reduce both the need for transfusions and the hospital length of stay in patients with preoperative iron deficiency anemia (IDA). In this study, we estimated the economic consequences of perioperative administration using FCM vs usual care in patients with IDA from the perspective of a German hospital using decision-analytic modeling. Materials and methods: The model was populated with clinical inputs (transfusion rates, blood units transfused, hospital length of stay) from a previously reported randomized trial comparing FCM vs usual care for managing IDA patients undergoing elective abdominal surgery...
2018: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/29706372/preoperative-anemia-versus-blood-transfusion-which-is-the-culprit-for-worse-outcomes-in-cardiac-surgery
#4
Damien J LaPar, Robert B Hawkins, Timothy L McMurry, James M Isbell, Jeffrey B Rich, Alan M Speir, Mohammed A Quader, Irving L Kron, John A Kern, Gorav Ailawadi
BACKGROUND: Reducing blood product utilization after cardiac surgery has become a focus of perioperative care as studies have suggested improved outcomes. The relative impact of preoperative anemia versus packed red blood cells (PRBC) transfusion on outcomes remains poorly understood, however. In this study, we investigated the relative association between preoperative hematocrit (Hct) level and PRBC transfusion on postoperative outcomes after coronary artery bypass grafting (CABG) surgery...
April 4, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29696301/-radical-cystectomy-and-urinary-diversion-what-is-important
#5
REVIEW
J Noldus, G Niegisch, A Pycha, A Karl
BACKGROUND: In Germany, radical cystectomy with urinary diversion is the primary therapeutic option for localized muscle invasive urothelial bladder cancer. Modifications in the pre-, peri-, and postoperative phase have significantly improved outcomes. OBJECTIVES: Different factors and parameters are directly associated with patients' outcome. An overview on how to best approach this procedure is provided in this article. MATERIALS AND METHODS: The data regarding preparation and the procedure for the radical cystectomy followed by urinary diversion are separately analyzed...
April 25, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29668544/splenectomy-to-optimize-hemoglobin-s-control-in-children-with-sickle-cell-anemia-on-chronic-transfusion-therapy-for-stroke-prevention
#6
L Vandy Black, Jolie S Ramesar, Catherine H Boston
Chronic transfusion therapy with the goal of maintaining a hemoglobin (Hb) S <30% is the primary recommended treatment for children with sickle cell anemia and a history of overt stroke or abnormal transcranial Doppler examination. We report chronic hypersplenism as a cause of poor HbS% control in 3 children on chronic transfusion therapy for stroke prevention. Splenectomy resulted in a 39.77% (95% confidence interval, 34.3-45.3, P<0.0001) mean reduction in HbS% with no perioperative or infectious complications suggesting the need for additional research into splenectomy as a therapeutic option for select high-risk children to optimize transfusion therapy for stroke prevention...
April 17, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29667729/hla-dqb1-03-genotype-and-perioperative-blood-transfusion-are-not-conducive-to-the-prognosis-of-patients-with-gastric-cancer
#7
Shen-Kang Zhou, Lei-Lei Yang, Rui Chen, Yong Lu, Yong-Hua Zheng
BACKGROUND: Gastric cancer (GC) is a disease associated with a higher incidence and mortality, and some host genetic polymorphisms have been reported as potential factors contributing to the development of GC. In view of this, the study was conducted to investigate the effects of HLA-DQB1 gene polymorphisms and perioperative blood transfusion on prognosis of patients with gastric cancer (GC). METHODS: A total of 142 patients with GC (case group) and 150 healthy controls (control group) were enrolled...
April 18, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29664113/peripartum-management-of-hla-alloimmune-platelet-refractoriness
#8
Jeremy Ryan Peña, Leanna Sudhof, Barbara O'Brien
BACKGROUND: Platelet (PLT) refractoriness presents a challenging problem for transfusion support, especially in the perioperative setting, where there is urgency for human leukocyte antigen (HLA)-compatible units, yet identification and provision of compatible PLT concentrates requires time. CASE REPORT: A 22-year-old G3P1 woman with thrombocytopenia due to aplastic anemia, likely autoimmune, presented in her third trimester for peripartum care and newly diagnosed HLA alloimmune PLT refractoriness...
April 17, 2018: Transfusion
https://www.readbyqxmd.com/read/29649614/missing-data-treatments-matter-an-analysis-of-multiple-imputation-for-anterior-cervical-discectomy-and-fusion-procedures
#9
Nathaniel T Ondeck, Michael C Fu, Laura A Skrip, Ryan P McLynn, Jonathan J Cui, Bryce A Basques, Todd J Albert, Jonathan N Grauer
BACKGROUND CONTEXT: The presence of missing data is a limitation of large datasets, including the National Surgical Quality Improvement Program (NSQIP). In addressing this issue, most studies utilize complete case analysis, which excludes cases with missing data, thus potentially introducing selection bias. Multiple imputation, a statistically rigorous approach that approximates missing data and preserves sample size, may be an improvement over complete case analysis. PURPOSE: To evaluate the impact of using multiple imputation in comparison to complete case analysis for assessing the associations between preoperative laboratory values and adverse outcomes following anterior cervical discectomy and fusion (ACDF) procedures...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29560399/tranexamic-acid-increases-early-perioperative-functional-outcomes-after-total-knee-arthroplasty
#10
Matthew J Grosso, David P Trofa, Jonathan R Danoff, Thomas R Hickernell, Taylor Murtaugh, Akshay Lakra, Jeffrey A Geller
Background: The purpose of this study was to investigate the influence of tranexamic acid (TXA) on functional outcomes in the immediate postoperative period after total knee arthroplasty (TKA). We hypothesized that the known benefits of TXA would confer measurable clinical improvements in physical therapy (PT) performance, decrease pain, and decrease hospital length of stay (LOS). Methods: We retrospectively analyzed 560 TKA patients, including 280 consecutive patients whose surgery was performed before the initiation of a standardized TXA protocol and the first 280 patients who received TXA after protocol initiation...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29555498/preoperative-anemia-is-associated-with-failure-of-open-debridement-polyethylene-exchange-in-acute-and-acute-hematogenous-prosthetic-joint-infection
#11
Richard D Swenson, James A Butterfield, Timothy J Irwin, John J Zurlo, Charles M Davis
BACKGROUND: Acute and acute hematogenous prosthetic joint infections (PJIs) are often treated with open debridement and polyethylene exchange (ODPE) in an effort to save the prosthesis, decrease morbidity, and reduce costs. However, failure of ODPE may compromise a subsequent 2-stage treatment. The purpose of this study is to identify patient factors that impact the success of ODPE for acute and acute hematogenous PJIs. METHODS: A retrospective review examined comorbidities, preoperative laboratory values, and patient history for patients with successful and failed ODPE treatment for acute perioperative or acute hematogenous periprosthetic hip or knee joint infections...
February 1, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29551302/impact-of-operative-time-on-adverse-events-following-primary-total-joint-arthroplasty
#12
Daniel D Bohl, Nathaniel T Ondeck, Brian Darrith, Charles P Hannon, Yale A Fillingham, Craig J Della Valle
BACKGROUND: Little is known regarding the impact of operative time on adverse events following arthroplasty. The present study tests for associations between a 15-minute increase in operative time and the occurrence of adverse events following primary total joint arthroplasty. METHODS: Patients undergoing primary total hip or knee arthroplasty during 2006-2013 were identified in the American College of Surgeons National Surgical Quality Improvement Program. Operative time (as a continuous variable) was tested for association with perioperative outcomes using multivariate regression...
February 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29534419/-clinical-features-analysis-of-metanephric-adenoma-a-series-of-16-cases
#13
Z Jia, C J Zhang, C G Xi, Y Q Gong, K W Yang, D Peng, L B Liu, J Li, X S Li, Z S He, L Q Zhou
Objective: To study the clinical characteristics, image findings, therapeutic method and prognosis of metanephric adenoma. Method: The clinical characteristic, image findings, operation methods and prognosis of 16 metanephric adenoma patients treated at Department of Urology, Peking University First Hospital from January 2004 to March 2016 were analyzed retrospectively. Results: There were 6 male and 10 female patients in the study. The mean age of patients was 33.7 years (ranging from 14 to 83 years). Two patients came to the hospital because of fever, while other 14 patients had no symptoms and found renal tumor by medical examination...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29521284/additional-dose-of-intravenous-tranexamic-acid-after-primary-total-knee-arthroplasty-further-reduces-hidden-blood-loss
#14
Zi-Jian Li, Min-Wei Zhao, Lin Zeng
Background: Total knee arthroplasty (TKA) is the most frequently performed procedure in treating advanced knee osteoarthritis. Excessive perioperative blood loss can sometimes lead to postoperative anemia. Tranexamic acid (TXA) is a potent fibrinolysis inhibitor which has been extensively used at the surgical incision and closure to lower overall blood loss in adult reconstruction surgery. Our previous study suggested that about two-thirds of the total blood loss (TBL) came from hidden blood loss (HBL) on postoperative days 1 and 2...
March 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29506817/results-after-laparoscopic-partial-splenectomy-for-children-with-hereditary-spherocytosis-are-outcomes-influenced-by-genetic-mutation
#15
Jakob Pugi, Manuel Carcao, Luke J Drury, Jacob C Langer
BACKGROUND: Laparoscopic partial splenectomy (LPS) theoretically maintains long-term splenic immune function for children with hereditary spherocytosis (HS). Our goal was to review our results after LPS and to determine if specific genetic mutations influence outcome. METHODS: All children with HS undergoing LPS between 2005 and 2016 were reviewed. RESULTS: Thirty-one children underwent LPS (16 male) at a median age of 9 (range 2-18) years...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29482908/blood-product-administration-in-the-critical-care-and-perioperative-settings
#16
REVIEW
Sofie Louise Rygård, Lars Broksø Holst, Anders Perner
The critical care and perioperative settings are high consumers of blood products, with multiple units and different products often given to an individual patient. The recommendation of this review is always to consider the risks and benefits for a specific blood product for a specific patient in a specific clinical setting. Optimize patient status by treating anemia and preventing the need for red blood cell transfusion. Consider other options for correction of anemia and coagulation disorders and use an imperative non-overtransfusion policy for all blood products...
April 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29468091/surgical-technical-evidence-review-for-elective-total-joint-replacement-conducted-for-the-ahrq-safety-program-for-improving-surgical-care-and-recovery
#17
REVIEW
Christopher P Childers, Anaar E Siletz, Emily S Singer, Claire Faltermeier, Q Lina Hu, Clifford Y Ko, Gregory J Golladay, Stephen L Kates, Elizabeth C Wick, Melinda Maggard-Gibbons
Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29462032/perioperative-allogeneic-red-blood-cell-transfusion-associated-with-surgical-site-infection-after-total-hip-and-knee-arthroplasty
#18
Joshua S Everhart, John H Sojka, Joel L Mayerson, Andrew H Glassman, Thomas J Scharschmidt
BACKGROUND: Perioperative allogeneic red blood-cell transfusion is a suspected risk factor for surgical site infection (SSI) after total joint arthroplasty (TJA), but the interrelationships among SSI risk, transfusion dose, preoperative anemia, and the presence of coagulopathies have not been well described. METHODS: Data on SSI within 1 year after surgery as well as on transfusion with blood products within 30 days after surgery were obtained for 6,788 patients who had undergone primary or revision total hip or knee arthroplasty from 2000 to 2011 in a single hospital system...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29452285/risk-factors-for-perioperative-morbidity-in-spine-surgeries-of-different-complexities-a-multivariate-analysis-of-1-009-consecutive-patients
#19
Mazda Farshad, David E Bauer, Cyrill Wechsler, Christian Gerber, Alexander Aichmair
BACKGROUND CONTEXT: There is a broad spectrum of complications during or after surgical procedures, with differing incidences reported in the published literature. Heterogeneity can be explained by the lack of an established evidence-based classification system for documentation and classification of complications in a standardized manner. PURPOSE: The objective of this study was to identify predictive risk factors for perioperative and early postoperative morbidities in spine surgeries of different complexities in a large cohort of consecutive patients...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29451943/dual-diagnosis-and-total-hip-arthroplasty
#20
Mitchell R Klement, Brian T Nickel, Abiram Bala, Colin T Penrose, Cynthia L Green, Samuel S Wellman, Michael P Bolognesi, Thorsten M Seyler
The co-occurrence of a mental illness and a substance abuse disorder (SUD) is common and has been referred to as a "dual diagnosis" (DD). Although studies have independently investigated mental illness alone and SUD alone, few have examined the effects of these entities combined on complications. A search of the Medicare database from 2005 to 2012 identified 2000 DD patients who underwent total hip arthroplasty (THA). They were compared with 86,976 patients with mental illness only and 590,689 controls (no mental illness or SUD)...
February 16, 2018: Orthopedics
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