The impact of perioperative blood transfusion on clinical outcomes in colorectal surgery

2007 ◽  
Vol 16 ◽  
pp. 177-182 ◽  
Author(s):  
G. Dionigi ◽  
F. Rovera ◽  
L. Boni ◽  
G. Carrafiello ◽  
C. Recaldini ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Blood Transfusion ◽  
Clinical Outcomes ◽  
The Impact ◽  
Perioperative Blood Transfusion

The Impact of Perioperative Blood Transfusion on Cancer Recurrence and Survival Following Radical Cystectomy

2013 ◽  
Vol 63 (5) ◽  
pp. 839-845 ◽  
Author(s):  
Brian J. Linder ◽  
Igor Frank ◽  
John C. Cheville ◽  
Matthew K. Tollefson ◽  
R. Houston Thompson ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Radical Cystectomy ◽  
Cancer Recurrence ◽  
The Impact ◽  
Perioperative Blood Transfusion

Nomogram to predict perioperative blood transfusion for hepatopancreaticobiliary and colorectal surgery

2016 ◽  
Vol 103 (9) ◽  
pp. 1173-1183 ◽  
Author(s):  
Y. Kim ◽  
F. Bagante ◽  
F. Gani ◽  
A. Ejaz ◽  
L. Xu ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Blood Transfusion ◽  
Perioperative Blood Transfusion

scholarly journals Effectiveness of pre-operative anaemia screening and increased Tranexamic acid dose on outcomes following unilateral primary, elective total hip or knee replacement: a statistical analysis plan for an interrupted time series and regression discontinuity study

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 224
Author(s):  
Ashley B. Scrimshire ◽  
Caroline Fairhurst ◽  
Catriona McDaid ◽  
David J. Torgerson
Keyword(s):  
Time Series ◽  
Statistical Analysis ◽  
Blood Transfusion ◽  
Knee Replacement ◽  
Regression Discontinuity ◽  
Interrupted Time Series ◽  
Statistical Analysis Plan ◽  
Study Designs ◽  
The Impact ◽  
Perioperative Blood Transfusion

Perioperative blood transfusion is associated with poorer postoperative outcomes following hip and knee replacement surgery. Evidence for the effectiveness of some measures aimed at reducing blood transfusions in this setting are limited and often rely on weak pre-post study designs. Quasi-experimental study designs such as interrupted time series (ITS) and regression discontinuity design (RDD) address many of the weaknesses of the pre-post study design. In addition, a priori publication of statistical analysis plans for such studies increases their transparency and likely validity, as readers are able to distinguish between pre-planned and exploratory analyses. As such, this article, written prospective of any analysis, provides the statistical analysis plan for an ITS and RDD study based on a data set of 20,772 primary elective hip and knee replacement patients in a single English NHS Trust. The primary aim is to evaluate the impact of a preoperative anaemia optimisation service on perioperative blood transfusion (within 7 days of surgery) using both ITS and RDD methods. A secondary aim is to evaluate the impact of a policy of increased tranexamic acid dose given at the time of surgery, using ITS methods.

scholarly journals Impact of early postoperative oral nutritional supplement utilization on clinical outcomes in colorectal surgery

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
David G. A. Williams ◽  
Tetsu Ohnuma ◽  
Vijay Krishnamoorthy ◽  
Karthik Raghunathan ◽  
Suela Sulo ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Propensity Score ◽  
Clinical Outcomes ◽  
Real World ◽  
Infectious Complications ◽  
Real World Data ◽  
Healthcare Database ◽  
Gastrointestinal Complications ◽  
Icu Admission ◽  
The Impact

Abstract Background Small randomized trials of early postoperative oral nutritional supplementation (ONS) suggest various health benefits following colorectal surgery (CRS). However, real-world evidence of the impact of early ONS on clinical outcomes in CRS is lacking. Methods Using a nationwide administrative-financial database (Premier Healthcare Database), we examined the association between early ONS use and postoperative clinical outcomes in patients undergoing elective open or laparoscopic CRS between 2008 and 2014. Early ONS was defined as the presence of charges for ONS before postoperative day (POD) 3. The primary outcome was composite infectious complications. Key secondary efficacy (intensive care unit (ICU) admission and gastrointestinal complications) and falsification (blood transfusion and myocardial infarction) outcomes were also examined. Propensity score matching was used to assemble patient groups that were comparable at baseline, and differences in outcomes were examined. Results Overall, patients receiving early ONS were older with greater comorbidities and more likely to be Medicare beneficiaries with malnutrition. In a well-matched sample of early ONS recipients (n = 267) versus non-recipients (n = 534), infectious complications were significantly lower in early ONS recipients (6.7% vs. 11.8%, P < 0.03). Early ONS use was also associated with significantly reduced rates of pneumonia (P < 0.04), ICU admissions (P < 0.04), and gastrointestinal complications (P < 0.05). There were no significant differences in falsification outcomes. Conclusions Although early postoperative ONS after CRS was more likely to be utilized in elderly patients with greater comorbidities, the use of early ONS was associated with reduced infectious complications, pneumonia, ICU admission, and gastrointestinal complications. This propensity score-matched study using real-world data suggests that clinical outcomes are improved with early ONS use, a simple and inexpensive intervention in CRS patients.

Impact of Blood Transfusion in Free Flap Breast Reconstruction Using Propensity Score Matching

2020 ◽  
Author(s):  
Efstathios Karamanos ◽  
Amita R. Shah ◽  
Julie N. Kim ◽  
Howard T. Wang
Keyword(s):  
Postoperative Complications ◽  
Blood Transfusion ◽  
Propensity Score ◽  
Breast Reconstruction ◽  
Propensity Score Matching ◽  
Free Flap ◽  
Improvement Program ◽  
National Quality ◽  
The Impact ◽  
Perioperative Blood Transfusion

Abstract Background Microvascular thrombosis has been associated with cytokine release and inflammatory syndromes which can occur as a result of blood transfusions. This phenomenon could potentially lead to complications in breast free flap reconstruction. The aim of this study was to evaluate the impact of perioperative blood transfusion in free flap breast reconstruction using large population analysis. Methods The American College of Surgeons National Quality Improvement Program database was queried for delayed free flap breast reconstructions performed in 2016. The study population was divided based on perioperative blood transfusion within 24 hours of the start of the operation. Propensity score matching analysis was used to ensure homogeneity between the two study groups. Primary outcome was unplanned return to the operating room (OR) within 30 days. Secondary outcomes were readmission and complications. Results A total of 1,256 patients were identified. Out of those, 91 patients received a perioperative blood transfusion. All the patients received only one unit of PRBC within the first 24 hours. Those patients were matched with similar patients who did not receive a transfusion on a ratio of 1:3 (273 patients). Patients who received a transfusion had a significantly higher incidence of reoperation (42 vs. 10%, p < 0.001). Patients who received a transfusion were more likely to return to the OR after 48 hours from the initial operation (13 vs. 5%, p = 0.001). All returns to the OR were due to flap-related complications. Perioperative blood transfusion increased the incidence of wound dehiscence (9 vs. 2%, p = 0.041) but had no protective effect on the development of other postoperative complications. Conclusion Perioperative blood transfusion in free flap breast reconstruction is associated with an increased probability of flap-related complications and subsequent return to the OR without decreasing the probability of developing other systemic postoperative complications.

Perioperative Blood Transfusion Is Associated With Worse Clinical Outcomes in Resected Lung Cancer

2014 ◽  
Vol 97 (5) ◽  
pp. 1827-1837 ◽  
Author(s):  
Ting Wang ◽  
Lili Luo ◽  
He Huang ◽  
Jingrui Yu ◽  
Changchuan Pan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Blood Transfusion ◽  
Clinical Outcomes ◽  
Perioperative Blood Transfusion

scholarly journals Impact of Early Postoperative Oral Nutritional Supplement Utilization on Clinical Outcomes in Colorectal Surgery

2020 ◽  
Author(s):  
David G.A. Williams ◽  
Tetsu Ohnuma ◽  
Vijay Krishnamoorthy ◽  
Karthik Raghunathan ◽  
Suela Sulo ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Propensity Score ◽  
Clinical Outcomes ◽  
Real World ◽  
Infectious Complications ◽  
Real World Data ◽  
Healthcare Database ◽  
Gastrointestinal Complications ◽  
Icu Admission ◽  
The Impact

Abstract Background: Small randomized trials of early postoperative oral nutritional supplementation (ONS) suggest various health benefits following colorectal surgery (CRS). However, real-world evidence of the impact of early ONS on clinical outcomes in CRS is lacking. Methods: Using a nationwide administrative-financial database (Premier Healthcare Database), we examined the association between early ONS use and postoperative clinical outcomes in patients undergoing elective open or laparoscopic CRS between 2008–2014. Early ONS was defined as the presence of charges for ONS before postoperative day (POD) 3. The primary outcome was composite infectious complications. Key secondary efficacy (intensive care unit (ICU) admission and gastrointestinal complications) and falsification (blood transfusion and myocardial infarction) outcomes were also examined. Propensity score matching was used to assemble patient groups that were comparable at baseline and differences in outcomes were examined.Results: Overall, patients receiving early ONS were older with greater comorbidities, and more likely to be Medicare beneficiaries with malnutrition. In a well-matched sample of early-ONS recipients (n=267) versus non-recipients (n= 534), infectious complications were significantly lower in early-ONS recipients (6.7% vs. 11.8%, P<0.03). Early-ONS use was also associated with significantly reduced rates of pneumonia (P<0.04), ICU admissions (P<0.04), and gastrointestinal complications (P<0.05). There were no significant differences in falsification outcomes. Conclusions: Although early postoperative ONS after CRS was more likely to be utilized in elderly patients with greater comorbidities, use of early ONS was associated with reduced infectious complications, pneumonia, ICU admission, and gastrointestinal complications. This propensity-score matched study using real-world data suggests that clinical outcomes are improved with early ONS use, a simple and inexpensive intervention in CRS patients.

Sign in / Sign up

Export Citation Format

Share Document