scholarly journals Estimated blood loss and anemia predict transfusion after total shoulder arthroplasty: a retrospective cohort study

2019 ◽  
Vol 3 (4) ◽  
pp. 311-315
Author(s):  
Katherine A. Burns ◽  
Lynn M. Robbins ◽  
Angela R. LeMarr ◽  
Amber L. Childress ◽  
Diane J. Morton ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Retrospective Cohort Study ◽  
Shoulder Arthroplasty ◽  
Retrospective Cohort ◽  
Total Shoulder Arthroplasty ◽  
Estimated Blood Loss

scholarly journals Day case versus inpatient total shoulder arthroplasty: A retrospective cohort study and cost-effectiveness analysis

2020 ◽  
Author(s):  
Aditya Borakati ◽  
Asad Ali ◽  
Chetana Nagaraj ◽  
Srinivas Gadikoppula ◽  
Michael Kurer
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Adverse Events ◽  
Retrospective Cohort Study ◽  
Shoulder Arthroplasty ◽  
Retrospective Cohort ◽  
Total Shoulder Arthroplasty ◽  
Mean Difference ◽  
Day Case ◽  
Significant Cost

AbstractBackgroundDay case total shoulder arthroplasty (TSA) is a novel approach, not widely practiced in Europe. We conducted a retrospective cohort study of patients comparing elective day case and inpatient TSAs in our UK centre.AimTo evaluate the efficacy and cost-effectiveness of day case total shoulder arthroplasty (TSA) compared to standard inpatient total shoulder arthroplasty.MethodsAll patients undergoing TSA between January 2017 and July 2018 were included. Outcome measures were: change in abduction and extension 3 months postoperatively; 30 day postoperative adverse events and re-admissions in day case and inpatient groups. We also conducted an economic evaluation of outpatient arthroplasty. Multivariate linear and logistic regression were used to adjust for demographic and operative covariates.Results59 patients were included, 18 day cases and 41 inpatients. There were no adverse events or re-admissions at 30 days postoperatively in either group. There were no significant differences in adjusted flexion (mean difference 16.4°; 95% CI -17.6° to 50.5°, p=0.337) or abduction (mean difference 13.2° 95% CI; -18.4° to 44.9°, p=0.405) postoperatively between groups. Median savings with outpatient arthroplasty were GBP 529 (IQR 247.33 to 789, p<0.0001).ConclusionDay case TSA is a safe, effective procedure, with significant cost benefit. Wider use may be warranted in the UK and beyond, with potential for significant cost savings and improved efficiency.Core tipIn this article we show that day case total shoulder arthroplasty is a feasible, safe and effective alternative to inpatient admission for the same procedure, with an associated average cost saving of GBP 529.

scholarly journals Anesthetic management in cesarean delivery of women with placenta previa: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dazhi Fan ◽  
Jiaming Rao ◽  
Dongxin Lin ◽  
Huishan Zhang ◽  
Zixing Zhou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Transfusion ◽  
Blood Loss ◽  
General Anesthesia ◽  
Cesarean Delivery ◽  
Retrospective Cohort ◽  
Placenta Previa ◽  
Neuraxial Anesthesia ◽  
Estimated Blood Loss ◽  
Maternal And Neonatal Outcomes

Abstract Background The incidence of placenta preiva is rising. Cesarean delivery is identified as the only safe and appropriate mode of delivery for pregnancies with placenta previa. Anesthesia is important during the cesarean delivery. The aim of this study is to assess maternal and neonatal outcomes of patients with placenta previa managed with neuraxial anesthesia as compared to those who underwent general anesthesia during cesarean delivery. Methods A retrospective cohort study was performed of all patients with placenta preiva at our large academic institution from January 1, 2014 to June 30, 2019. Patients were managed neuraxial anesthesia and general anesthesia during cesarean delivery. Results We identified 1234 patients with placenta previa who underwent cesarean delivery at our institution. Neuraxial anesthesia was performed in 737 (59.7%), and general anesthesia was completed in 497 (40.3%) patients. The mean estimated blood loss at neuraxial anesthesia of 558.96 ± 42.77 ml were significantly lower than the estimated blood loss at general anesthesia of 1952.51 ± 180 ml (p < 0.001). One hundred and forty-six of 737 (19.8%) patients required blood transfusion at neuraxial anesthesia, whereas 381 out of 497 (76.7%) patients required blood transfusion at general anesthesia. The rate neonatal asphyxia and admission to NICU at neuraxial anesthesia was significantly lower than general anesthesia (2.7% vs. 19.5 and 18.2% vs. 44.1%, respectively). After adjusting confounding factors, blood loss was less, Apgar score at 1- and 5-min were higher, and the rate of blood transfusion, neonatal asphyxia, and admission to NICU were lower in the neuraxial group. Conclusions Our data demonstrated that neuraxial anesthesia is associated with better maternal and neonatal outcomes during cesarean delivery in women with placenta previa.

scholarly journals Comparison Between Bilateral Simultaneous Total Hip Arthroplasty With and Without Drainage; a Retrospective Cohort Study

2021 ◽  
Author(s):  
Min-Gwang Kim ◽  
Taek-Rim Yoon ◽  
Kyung-Soon Park
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Postoperative Bleeding ◽  
Total Blood Loss ◽  
Postoperative Blood Loss ◽  
Consecutive Series ◽  
Transfusion Rate ◽  
Total Blood

Abstract BackgroundThere are many reports staged bilateral THA without drainage is a better method than with drainage in many ways. However, there is little report regarding bilateral simultaneous THA (BSTHA) without drainage. This study aimed to evaluate the differences in the clinical outcomes and complication rate of BSTHA with drainage and without drainage.MethodsBetween October 2015 and April 2019, a retrospective cohort study was conducted with modified minimally invasive two-incision method and a consecutive series of 41 BSTHA performed with drainage were compared to 37 BSTHA performed without drainage. It was assessed clinically and radiographically for a mean of 2.1 ± 0.8 years (range, 1.0-4.8 years). Postoperative hematologic values (Hgb drop, Hct drop, total blood loss, transfusion rate), pain susceptibility, functional outcome, and complication were compared in the drained group and the non-drained group. All patients preoperatively received intravenous tranexamic acid (TXA) and intraoperatively received intra-articular TXA on each hip. Statistical analyses were performed using the independent t tests, Chi-squared or Fisher’s exact tests. A significance level of ≤ 0.05 was used for all statistical tests.Results Mean postoperative Hgb (g/dL, p < 0.001) & Hct drop (%, p < 0.001), mean total blood loss (ml, p < 0.001) and mean transfusion unit (IU, p < 0.001) were significantly lower in the BSTHA without drainage than in the BSTHA with drainage group. But the mean dose of morphine equivalent (mg, p < 0.001) was significantly larger in BSTHA without drainage.ConclusionBSTHA without drainage can reduce postoperative blood loss and the requirement for transfusion without increasing other complication. But BSTHA without drainage is more painful method than BSTHA with drainage. Therefore, BSTHA without drainage will be a good option to reduce the burden on the patient by reducing postoperative bleeding if it can control pain well after surgery.

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