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transfusion practice variability

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https://www.readbyqxmd.com/read/28523403/sleeve-gastrectomy-postoperative-hemorrhage-is-linked-to-type-2-diabetes-and-not-to-surgical-technique
#1
Hadar Spivak, Carmil Azran, Galia Spectre, Galina Lidermann, Orit Blumenfeld
BACKGROUND: The degree, prevalence, and risk factors linked to sleeve gastrectomy (SG) postoperative hemorrhage (POH) have not been fully defined. METHODS: An analysis was conducted on a prospectively collected database of 394 consecutive primary SGs performed in a single practice from January 2014 to December 2015. END POINTS: (1) acute POH, defined by red blood cell (RBC) transfusion and/or re-exploration; (2) subclinical POH, defined by postoperative hemoglobin drop (HgbD) >one standard deviation above mean...
May 18, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28488962/strategies-for-reducing-the-risk-of-transfusion-transmitted-leishmaniasis-in-an-area-endemic-for-leishmania-infantum-a-patient-and-donor-targeted-approach
#2
Teresa Jimenez-Marco, Cristina Riera, Enrique Girona-Llobera, Carmen Guillen, Laura Iniesta, Magdalena Alcover, Diana Berenguer, Alba Pujol, Miriam Tomás-Pérez, Beatriz Cancino-Faure, Teresa Serra, Martín Mascaró, Joan Gascó, Roser Fisa
BACKGROUND: In the Balearic Islands, as in other areas of the Mediterranean basin, there is a significant proportion of asymptomatic Leishmania (L.) infantum-infected blood donors, who may represent an important threat to transfusion safety. The Balearic Islands blood bank, located in an area endemic for L. infantum, carried out a study of donors and patients to investigate the impact of this infectious disease on blood safety in the region. MATERIALS AND METHODS: Twenty asymptomatic Leishmania-infected blood donors were followed-up between 2008 and 2011 to investigate the evolution of Leishmania infection in asymptomatic carriers...
March 15, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28458067/effect-of-liberal-blood-transfusion-on-clinical-outcomes-and-cost-in-spine-surgery-patients
#3
Taylor E Purvis, C Rory Goodwin, Rafael De la Garza-Ramos, A Karim Ahmed, Virginie Lafage, Brian J Neuman, Peter G Passias, Khaled M Kebaish, Steven M Frank, Daniel M Sciubba
BACKGROUND CONTEXT: Blood transfusions in spine surgery are shown to be associated with increased patient morbidity. The association between transfusion performed using a liberal hemoglobin trigger-defined as an intraoperative hemoglobin level of ≥10 g/dL, a postoperative level of ≥8 g/dL, or a whole hospital nadir between 8-10 g/dL-and perioperative morbidity and cost in spine surgery patients is unknown and thus was investigated in this study. PURPOSE: To describe the perioperative outcomes and economic cost associated with liberal hemoglobin trigger transfusion among spine surgery patients...
April 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28450103/regional-variation-in-outcomes-for-lower-extremity-vascular-disease-in-the-vascular-quality-initiative
#4
Peter A Soden, Sara L Zettervall, Katie E Shean, Ageliki G Vouyouka, Philip P Goodney, Joseph L Mills, John W Hallett, Marc L Schermerhorn
BACKGROUND: Increased focus has been placed on perioperative and long-term outcomes in the treatment of peripheral artery disease (PAD), both for purposes of quality improvement and for assessment of performance at a surgeon and institutional level. This study evaluates regional variation in outcomes after treatment for PAD within the Vascular Quality Initiative (VQI). By describing the variation in practice patterns and outcomes across regions, we hope that each regionally based quality group can select which areas are most important for them to focus on as they will have access to their regional data to compare...
April 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28426586/predictive-modeling-of-massive-transfusion-requirements-during-liver-transplantation-and-its-potential-to-reduce-utilization-of-blood-bank-resources
#5
Aliaksei Pustavoitau, Maggie Lesley, Promise Ariyo, Asad Latif, April J Villamayor, Steven M Frank, Nicole Rizkalla, William Merritt, Andrew Cameron, Nabil Dagher, Benjamin Philosophe, Ahmet Gurakar, Allan Gottschalk
BACKGROUND: Patients undergoing liver transplantation frequently but inconsistently require massive blood transfusion. The ability to predict massive transfusion (MT) could reduce the impact on blood bank resources through customization of the blood order schedule. Current predictive models of MT for blood product utilization during liver transplantation are not generally applicable to individual institutions owing to variability in patient population, intraoperative management, and definitions of MT...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28387644/medical-necessity-of-routine-admission-of-children-with-mild-traumatic-brain-injury-to-the-intensive-care-unit
#6
Jared D Ament, Krista N Greenan, Patrick Tertulien, Joseph M Galante, Daniel K Nishijima, Marike Zwienenberg
OBJECTIVE Approximately 475,000 children are treated for traumatic brain injury (TBI) in the US each year; most are classified as mild TBI (Glasgow Coma Scale [GCS] Score 13-15). Patients with positive findings on head CT, defined as either intracranial hemorrhage or skull fracture, regardless of severity, are often transferred to tertiary care centers for intensive care unit (ICU) monitoring. This practice creates a significant burden on the health care system. The purpose of this investigation was to derive a clinical decision rule (CDR) to determine which children can safely avoid ICU care...
April 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28383471/clinical-practice-guideline-adherence-during-operation-inherent-resolve
#7
Timothy P Plackett, Darren C Cherry, Gerald Delk, Steven Satterly, Jared Theler, Derek McVay, Jacqueline Moore, Stacy A Shackelford
BACKGROUND: The Joint Trauma System (JTS) Clinical Practice Guidelines (CPGs) contributed to the decrease in battlefield morality over the past 15 years. However, it is unknown to what degree the guidelines are being followed in current military operations. METHODS: A retrospective review was performed of all patients treated at three separate US Army Role II facilities during the first ten months of Operation Inherent Resolve in Iraq. Charts were reviewed for patient demographics, clinical care, and outcomes...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28370487/contrast-induced-nephropathy-in-patients-undergoing-endovascular-peripheral-vascular-intervention-incidence-risk-factors-and-outcomes-as-observed-in-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium
#8
P Michael Grossman, Syed S Ali, Herbert D Aronow, Michael Boros, Timothy J Nypaver, Theodore L Schreiber, Yeo Jung Park, Peter K Henke, Hitinder S Gurm
BACKGROUND: The incidence, risk factors, and outcomes associated with Contrast-induced nephropathy (CIN) after Percutaneous Vascular Intervention (PVI) in contemporary medical practice are largely unknown. METHODS: A total of 13 126 patients undergoing PVI were included in the analysis. CIN was defined as an increase in serum creatinine from pre-PVI baseline to post-PVI peak Cr of ≥0.5 mg/dL. RESULTS: CIN occurred in 3% (400 patients) of the cohort, and 26 patients (6...
April 3, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28369475/national-trends-and-variability-in-blood-utilization-in-paediatric-cardiac-surgery
#9
Mohsen Karimi, Jill M Sullivan, Trudy Lerer, Carla Hronek
OBJECTIVES: Red blood cell transfusion is a common practice in paediatric cardiac surgery. Transfusion of red blood cells has been shown to be associated with an increase in morbidity in paediatric patients undergoing cardiac surgery. There is a huge variability in the practice of blood utilization within and across different practices. The aim of this study was to demonstrate the current variability and the trends over the past decade in blood usage among children's hospitals performing paediatric cardiac surgery...
March 28, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28358766/early-complications-and-associated-perioperative-factors-in-nonsyndromic-craniosynostosis
#10
Yunhe Lu, Abdulsamad Ghanem, Tianyi Cai, Junyi Yang, Xiongzheng Mu
This is the first Eastern center-based retrospective report on early complications and associated perioperative factors of nonsyndromic craniosynostosis (NSC). The authors' purpose is to tailor preoperative counseling, convey objective perioperative data, and determinants for early complications in NSC so as to enhance exchanges with international center. Inclusion criteria required a diagnosis of NSC confirmed by 3-dimentional computed tomography scans and complete medical record. Genetic evidence of syndromic craniosynostosis was excluded...
March 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28358763/whole-blood-in-pediatric-craniofacial-reconstruction-surgery
#11
Princy Thottathil, Deborah Sesok-Pizzini, Jesse A Taylor, John E Fiadjoe, Ariel Vincent, Paul A Stricker
BACKGROUND: Pediatric complex cranial vault reconstruction (CCVR) surgery is often associated with significant blood loss and transfusion. The authors recently changed our transfusion practice during CCVR to using whole blood (WB) instead of reconstituted blood (RB). The aim of this study was to assess the impact of this practice change. Our hypothesis was that replacement with WB would be as effective as RB for the outcomes of total perioperative blood donor exposures (BDEs) and the incidence of laboratory evidence of postoperative coagulopathy...
March 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28338513/restrictive-transfusion-practices-after-esophagectomy-are-associated-with-improved-outcome-a-review-of-the-society-of-thoracic-surgeons-general-thoracic-database
#12
Christopher W Towe, Brian C Gulack, Sunghee Kim, Vanessa P Ho, Yaron Perry, James M Donahue, Philip A Linden
OBJECTIVE: Blood transfusion has been associated with poor outcomes in many disciplines, yet transfusion practices and related outcomes in esophagectomy are unknown. We analyzed the Society of Thoracic Surgeons General Thoracic Database to determine patient factors associated with transfusion after esophagectomy, risk-adjusted variation in transfusion practice among institutions, and the association of transfusion practice with mortality. METHODS: We performed a retrospective review of patients undergoing esophagectomy for cancer from October 2008 to December 31, 2014...
March 23, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#13
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28319015/collection-storage-inspection-and-quality-control-of-platelet-concentrates-obtained-by-apheresis-the-situation-in-spain
#14
Azucena Castrillo, Teresa Jimenez-Marco, José L Arroyo, María L Jurado, Luis Larrea, Rosa M Maymo, Jorge Monge, Carmen Muñoz, Ángel Pajares, Marta Yáñez
BACKGROUND: Diverse variables are involved in apheresis platelet collection, processing and storage. This survey shows how these are realized in Spain. METHOD: An analysis of collected data was performed in a questionnaire completed by ten Transfusion Centers (TC) which perform between 50 and 520 apheresis procedures per month. This information comprises the procedures used to collect, inspect and store apheresis platelet concentrates (PC), and quality control data...
February 22, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28306708/linking-hepatitis-c-virus-infection-to-pre-1994-blood-transfusions-in-female-patients
#15
Christian Ramos Flores, Ernesto Echeagaray, Guadalupe Castañeda, Maria de Lourdes Vargas, Raúl Montes-González, Susana Luna, Laura Díaz, Oscar Torres
INTRODUCTION: Most blood transfusions occur in female patients. The introduction of serologic screening practices by blood banks reduced the transfusion-related rate of infection with hepatitis C virus (HCV). In Mexico patients with pre-1994 transfusion history are at high risk of being detected with HCV infection. We aimed at establishing an interrelationship between two variables: pre-1994 transfusion history and rate of infection in women treated in the Guadalajara Metropolitan Area hospitals, in Mexico...
March 15, 2017: Medwave
https://www.readbyqxmd.com/read/28282628/blood-transfusion-indications-in-neurosurgical-patients-a-systematic-review
#16
REVIEW
Shefali Bagwe, Lawrance K Chung, Carlito Lagman, Brittany L Voth, Natalie E Barnette, Lekaa Elhajjmoussa, Isaac Yang
Neurosurgical procedures can be complicated by significant blood losses that have the potential to decrease tissue perfusion to critical brain tissue. Red blood cell transfusion is used in a variety of capacities both inside, and outside, of the operating room to prevent untoward neurologic damage. However, evidence-based guidelines concerning thresholds and indications for transfusion in neurosurgery remain limited. Consequently, transfusion practices in neurosurgical patients are highly variable and based on institutional experiences...
April 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28266049/standardization-of-transfusion-practice-in-organ-donors-using-the-digital-intern-an-electronic-decision-support-algorithm
#17
Joseph P Connor, Ashley M Cunningham, Thomas Raife, William N Rose, Joshua E Medow
BACKGROUND: Prospective clinical trials support restrictive thresholds for red blood cell (RBC) transfusion. Nonsurvivable donors are a major source of organs for transplantation. The Digital Intern (DI) is a computer algorithm to standardize donor care that includes a more restrictive transfusion threshold. The impact of standardized and restrictive RBC transfusion in organ donors, as determined by the DI, has not been reported. STUDY DESIGN AND METHODS: We conducted a retrospective cohort study to compare the transfusion practice of the DI (n = 100) to a historic group of physician-managed donors (n = 90)...
March 7, 2017: Transfusion
https://www.readbyqxmd.com/read/28261815/the-practice-of-platelet-transfusion-prior-to-central-venous-catheterization-in-presence-of-coagulopathy-a-national-survey-among-clinicians
#18
E K van de Weerdt, A L Peters, E J Goudswaard, J M Binnekade, K P van Lienden, B J Biemond, A P J Vlaar
BACKGROUND: Correction of coagulopathy prior to central venous catheter (CVC) placement is advocated by guidelines, while retrospective studies support restrictive use of transfusion products. STUDY DESIGN AND METHODS: We conducted a mixed vignette and questionnaire web survey to investigate current practice and preferences for CVC placement. Clinical vignettes were used to quantify the tendency to administer platelet concentrate. A positive ß-coefficient is in favour of administering platelet concentrate...
March 5, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28258304/orthopaedic-trauma-surgeons-and-direct-anterior-total-hip-arthroplasty-evaluation-of-learning-curve-at-a-level-i-academic-institution
#19
Philip J York, Stephanie L Logterman, David J Hak, Andreas Mavrogenis, Cyril Mauffrey
BACKGROUND: Interest in the direct anterior approach for total hip arthroplasty has increased over recent years; however, the potential for substantial complications exists, especially during the surgeon's learning curve. We evaluated the change in various metrics to help identify a single surgeon's learning curve. Additionally, we examined whether the learning curve was different for primarily arthroplasty versus trauma-trained surgeons. METHODS: We reported outcomes from the first 50 total hip arthroplasties performed through a direct anterior approach by a trauma fellowship-trained orthopaedic surgeon...
March 3, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28236313/an-international-survey-on-the-role-of-the-hospital-transfusion-committee
#20
Mark H Yazer, Miguel Lozano, Mark Fung, Jose Kutner, Michael F Murphy, Torunn Oveland Apelseth, Ryszard Pogłód, Kathleen Selleng, Alan Tinmouth, Silvano Wendel, Vered Yahalom
BACKGROUND: Hospital transfusion committees (HTCs) can oversee all aspects of transfusion practice at a hospital. This survey sought to identify which quality variables were being reported at HTCs around the world. STUDY DESIGN AND METHODS: A working party composed of members of the Biomedical Excellence for Safer Transfusion (BEST) collaborative developed a survey of quality variables that could be potentially presented at HTC meetings. The survey was electronically sent to all BEST members who were encouraged to complete it if they were active on an HTC and to send it to other colleagues with similar experience...
May 2017: Transfusion
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