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Preoperative anemia

Andra H James, Chad Grotegut, Homa Ahmadzia, Cathleen Peterson-Layne, Evelyn Lockhart
The purpose of this article is to review the use of blood products and hemostatic agents in the management of coagulopathy at the time of postpartum hemorrhage. Blood product administration strategies are broadly reviewed, including the role of the blood bank, the role of massive transfusion protocols, the role of laboratory monitoring, and the role of anesthesia management. Aspects of patient blood management are discussed. The concept refers to an evidence-based, comprehensive, multidisciplinary approach to optimizing the care of patients who might need transfusion and includes measures to avoid or minimize transfusion such as preoperative anemia management, cell salvage, and the use of hemostatic medication to reduce bleeding...
October 3, 2016: Seminars in Thrombosis and Hemostasis
Vaughn E Nossaman, William S Richardson, James B Wooldridge, Bobby D Nossaman
INTRODUCTION: A recent bariatric surgical study demonstrated an inverse relationship of intraoperative hydration with the incidence of extended hospital length of stay (ehLOS: >1 postoperative hospital day). In that study, a post hoc analysis of the preoperative duration of Nil Per Os (NPO) past midnight revealed a significant dose-response association on the incidence of ehLOS, with the lowest incidence (10-12 %) predicted within the 2-5-h NPO interval. As NPO is associated with a state of compensatory dehydration, the objectives of this study were to prospectively examine the role of decreasing preoperative NPO intervals on the incidence of ehLOS in a similar bariatric surgical population and to establish causality of this association...
September 27, 2016: Surgical Endoscopy
Xiaoming Yuan, Guangrong Zhou, Yan He, Aiwen Feng
BACKGROUND: Epithelial dysplasia and adenomatous polyps of colorectum are precancerous lesions. Surgical removal is still one of the important treatment approaches for colorectal polyps. CASE PRESENTATION: A male patient over 78 years was admitted due to bloody stool and abdominal pain. Colonoscopic biopsy showed a high-grade epithelial dysplasia in an adenomatous polyp of sigmoid colon. Anemia, COPD, ischemic heart disease (IHD), arrhythmias, and hypoproteinemia were comorbidities...
September 26, 2016: World Journal of Surgical Oncology
Leilei Xia, Thomas J Guzzo
PURPOSE: The aim of this study was to determine the effect of preoperative anemia status and hemoglobin level on clinical outcomes in patients with bladder cancer undergoing radical cystectomy. MATERIALS AND METHODS: A systematic review of literature with meta-analyses of predefined outcomes based on a search of PubMed and EMBASE was performed. Hazard ratios (HRs) measuring the association between preoperative anemia/hemoglobin and all-cause mortality, cancer-specific mortality, and disease recurrence were calculated with random effects model...
August 29, 2016: Clinical Genitourinary Cancer
Anupam Kapur, Ranjeeta Angomchanu, Madhusudan Dey
BACKGROUND: Fibroid or myoma is the commonest reported tumor of uterus, and is one of the important reasons for hysterectomy in our setting. Different drugs are available for medical management of fibroid uterus including mifepristone, a progesterone antagonist. Varying dosage regimen for mifepristone was studied as medical management of fibroid uterus. The aim of the project was to study the effect of mifepristone on the symptoms and size of fibroids, especially using a low-dose regimen for 6 months...
October 2016: Journal of Obstetrics and Gynaecology of India
Brian Dix, Lisa Grant-McDonald, Alan Catanzariti, Karl Saltrick
: This is a retrospective study (n = 39) evaluating the postoperative outcomes of patients with mild to moderate preoperative anemia who underwent a hindfoot and/or ankle arthrodesis. In the study, 32 patients did not have preoperative anemia, and 7 had preoperative anemia. Mortality, length of hospital stay, blood transfusions, deep-vein thrombosis, infection, time to union, malunion, delayed union, nonunion, and ulceration were of particular interest. Comparative analyses between patients with preoperative anemia and those without were performed utilizing the independent samples t-test or by the nonparametric Mann-Whitney U-test...
September 9, 2016: Foot & Ankle Specialist
Jin Young Lee, Seung Hwan Lee, Myung Jae Jung, Jae Gil Lee
Few studies have evaluated the risk factors for in-hospital mortality in critically ill surgical patients who have undergone emergency gastrointestinal (GI) surgery. The aim of this study was to identify the risk factors associated with in-hospital mortality in critically ill surgical patients after emergency GI surgery.The medical records of 362 critically ill surgical patients who underwent emergency GI surgery, admitted to intensive care unit between January 2007 and December 2011, were reviewed retrospectively...
August 2016: Medicine (Baltimore)
Yuichi Matsuzaki, Hideyuki Tomioka, Masaki Saso, Takashi Azuma, Satoshi Saito, Shigeyuki Aomi, Kenji Yamazaki
BACKGROUND: Hereditary spherocytosis is a genetic, frequently familial hemolytic blood disease characterized by varying degrees of hemolytic anemia, splenomegaly, and jaundice. There are few reports on adult open-heart surgery for patients with hereditary spherocytosis. CASE PRESENTATION: We report a rare case of an adult open-heart surgery associated with hereditary spherocytosis. A 63-year-old man was admitted for congestive heart failure due to bicuspid aortic valve, aortic valve regurgitation, and sinus of subaortic aneurysm...
2016: Journal of Cardiothoracic Surgery
Katrine Praetorius, Christian M Madsen, Bo Abrahamsen, Henrik L Jørgensen, Jes B Lauritzen, Anne Sofie B Laulund
INTRODUCTION: Previous smaller studies suggest that anemia is a risk factor for mortality in patients with hip fracture. The purpose of this investigation was to assess the correlation between hemoglobin at admission with 30-day mortality following a hip fracture in a large-scale study. PATIENTS AND METHODS: From January 1996 to December 2012, all patients with hip fracture (>60 years of age) admitted to Bispebjerg Hospital, Copenhagen, were identified from a local hip fracture database...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Masataka Tochimoto, Toru Watanabe, Karin Sadamura, Yoshitaka Iwaki, Yuta Horiguchi, Kanae Tawaraya, Hideaki Katoh, Masahiko Kawaguchi, Osamu Hosokawa, Kunio Yanagimoto
The first patient was a man in his eighties who visited our department because of anemia. Gastrofiberscopy revealed a bleeding submucosal tumor, approximately 50mm in diameter, in the cardia ofthe stomach. Considering that he underwent coronary-artery bypass surgery and received 3 oral antithrombotic medicines, his bleeding tendency was so high that we decided to choose partial gastrectomy. A postoperative histopathological examination revealed that the tumor was a small cell endocrine carcinoma. The second patient was a woman in her seventies...
August 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
X J Ye, W L Zhong, L L Xiong, K Ma, T Xu, X B Huang, X F Wang
OBJECTIVE: To evaluate the clinical effect of retroperitoneoscopic renal pedicle lymphatic disconnection via extra-adipose capsule in the management of chyluria and to discuss the management of its complications. METHODS: From August 2013 to June 2008, five patients with chyluria were admitted. All the patients were female, aged from 26 to 73 years, and disease course from 1 to 10 years. All the five patients had complained of intermittently voiding milky urine with varying degrees of weight loss, and fatigue, of whom two presented with flank pain and one with anemia...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Young Wook Lim, Seung Chan Kim, Soon Yong Kwon, Do Joon Park, Yong Sik Kim
PURPOSE: Patients with aplastic anemia (AA) are now living longer and therefore are at increased risk for the development of osteonecrosis of the hip. However, studies on the results of total hip arthroplasty (THA) are lacking. The purpose of this study is to present the result of THA in patients with AA. MATERIALS AND METHODS: We retrospectively reviewed the data for a group of 29 patients (45 hips) with AA who presented to our institution for THA between May 2008 and May 2012...
March 2016: Hip Pelvis
Jong Hee Lee, Seung Beom Han
Perioperative blood transfusions are common in total hip arthroplasty because of preoperative anemia and perioperative blood loss. Perioperative anemia and the need for allogeneic blood transfusion are related with increased morbidity. To reduce perioperative allogeneic blood transfusion, keeping the preoperative hemoglobin level above 12.0 g/dL is important in orthopedic patients. By using the anti-fibrinolytic agent or perioperative cell salvage, reduce intraoperative blood loss is very important for the reduction of perioperative blood loss...
December 2015: Hip Pelvis
Mariano E Menendez, David Ring, Andrew Jawa
BACKGROUND: Patient falls are one of the most commonly reported safety incidents in hospitals and an important cause of harm. Despite growing interest in postoperative fall prevention, data on the extent and correlates of falls among elective orthopedic inpatients are sparse and confined to lower limb arthroplasty. We evaluated inpatient fall trends after elective shoulder arthroplasty and identified patient and hospital characteristics associated with the occurrence of falls. METHODS: We used discharge records from the Nationwide Inpatient Sample (2002-2011)...
August 10, 2016: Journal of Shoulder and Elbow Surgery
Steffen Rausch, Stephan Kruck, Kerstin Walter, Arnulf Stenzl, Jens Bedke
OBJECTIVE: To define the predictive capability of serum C-reactive protein for a contemporary patient collective undergoing metastasectomy for metastatic renal cell carcinoma with access to modern targeted therapies. METHODS: A total of 88 patients treated with metastasectomy for metastatic renal cell carcinoma from 2003 to 2014 were evaluated for putative clinicopathological risk factors and survival. Kaplan-Meier analyses, univariate and multivariate testing were carried out...
August 12, 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Gustaf Klinga, Amir Sherif
BACKGROUND AND OBJECTIVE: Neoadjuvant chemotherapy (NAC) can be associated with anemia, which can lead to more perioperative blood transfusions (PBT). Usage of PBT is associated with worse oncological outcomes. We evaluated the prevalence of preoperative anemia (PA) and the effect on hemoglobin levels depending on surgery timing after NAC. METHODS: A retrospective single-center study with 240 consecutive patients undergoing radical cystectomy (RC) between 2001 and 2014 for muscle-invasive urothelial carcinoma (MIBC)...
2016: SpringerPlus
Aditya V Karhade, Viren S Vasudeva, Hormuzdiyar H Dasenbrock, Yi Lu, William B Gormley, Michael W Groff, John H Chi, Timothy R Smith
OBJECTIVE The goal of this study was to use a large national registry to evaluate the 30-day cumulative incidence and predictors of adverse events, readmissions, and reoperations after surgery for primary and secondary spinal tumors. METHODS Data from adult patients who underwent surgery for spinal tumors (2011-2014) were extracted from the prospective National Surgical Quality Improvement Program (NSQIP) registry. Multivariable logistic regression was used to evaluate predictors of reoperation, readmission, and major complications (death, neurological, cardiopulmonary, venous thromboembolism [VTE], surgical site infection [SSI], and sepsis)...
August 2016: Neurosurgical Focus
Adetokunbo O Tayo, Adedoyin O Dosunmu, Ireti O Akinola, Adeniyi Adewunmi, Olufemi A Oloyede, Akinsegun A Akinbami, Bodunrin I Osikomaiya, Samira B L Makanjuola
OBJECTIVE: Anemia in patients presenting for elective surgery is associated with increased morbidity, allogeneic blood transfusion, and delay of surgery. Extract of sorghum bicolor has been shown to have hemopoietic, immune-stimulating, and antioxidant effects in rats and in patients with HIV. The aim of this study was to determine the effect of the extract in patients with preoperative anemia booked for myomectomy. METHODS: Consenting patients (N = 66) were randomly assigned to two groups...
May 18, 2016: Nutrition
Christian von Heymann, Lutz Kaufner, Michael Sander, Claudia Spies, Karina Schmidt, Hans Gombotz, Klaus-Dieter Wernecke, Felix Balzer
BACKGROUND: Preoperative anemia and transfusion are associated with increased morbidity and mortality in cardiac surgery patients. It is unclear which of these factors plays the leading role in poor outcomes after cardiac surgery. The goal of this study was to analyze the influence of anemias of varying severity and intraoperative transfusion on long-term survival, and to characterize their interaction in cardiac surgery patients. METHODS: This was an observational cohort study conducted at a German university hospital...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Milo Engoren, Russell R Brown, Anna Dubovoy
PURPOSE: Acute anemia is associated with both cerebral dysfunction and acute kidney injury and is often treated with red blood cell transfusion. We sought to determine if blood transfusion changed the cerebral oximetry entropy, a measure of the complexity or irregularity of the oximetry values, and if this change was associated with subsequent acute kidney injury. METHODS: This was a retrospective, case-control study of patients undergoing cardiac surgery with cardiopulmonary bypass at a tertiary care hospital, comparing those who received a red blood cell transfusion to those who did not...
July 20, 2016: Perfusion
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