Blood transfusion after cardiac surgery increases the hospital length of stay in adult patients

Purpose Adequate resuscitation and definitive hemostasis are both important in the management of hemorrhage related to pelvic fracture. The goal of this study was to analyze the relationship between the amount of blood transfused before transcatheter arterial embolization (TAE) and the clinical outcome later in the disease course. Methods Patients with pelvic fractures who underwent TAE for hemostasis from January 2018 to December 2019 were studied. The characteristics of patients who received blood transfusions of >2 U (1000 mL) and ≤2 U before TAE were compared. The mortality rate, blood transfusion-related complications, and length of stay were compared between these two groups. Results Among the 75 studied patients, 39 (52.0%) received blood transfusions of ≤2 U before TAE, and the other 36 (48.0%) patients received blood transfusions of >2 U before TAE. The incidence rates of systemic inflammatory response syndrome, sepsis, and coagulopathy were significantly higher in the >2 U group (97.2% vs 81.1%, P = .027; 50.0% vs 27.0%, P = .045; and 44.4% vs 5.4%, P < .01, respectively). After nonsurvivors were excluded, the >2 U group had a significantly higher proportion (43.8% vs 14.7%, P < .001) of prolonged intensive care unit (ICU) length of stay (7 days or more) and a longer hospital length of stay (33.8 ± 15.1 vs 21.9 ± 94.0, P < .01) than the ≤2 U group. Pre-TAE blood transfusion >2 U serves as an independent risk factor for prolonged ICU length of stay and increased hospital length of stay. Conclusion Early hemostasis for pelvic fracture-related hemorrhage is suggested to prevent pre-TAE blood transfusion-associated adverse effects of blood transfusion.

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The Impact of Compartment Syndrome on Hospital Length of Stay and Charges Among Adult Patients Admitted With a Fracture of the Tibia

Journal of Orthopaedic Trauma ◽

10.1097/bot.0b013e3181f18ad8 ◽

2011 ◽

Vol 25 (6) ◽

pp. 355-357 ◽

Cited By ~ 29

Author(s):

Andrew H Schmidt

Keyword(s):

Length Of Stay ◽

Compartment Syndrome ◽

Hospital Length ◽

Adult Patients ◽

Hospital Length Of Stay ◽

The Impact

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Lactate levels after major cardiac surgery are associated with hospital length of stay

Critical Care ◽

10.1186/cc14273 ◽

2015 ◽

Vol 19 (Suppl 1) ◽

pp. P193

Author(s):

LW Andersen ◽

M Holmberg ◽

P Patel ◽

KM Berg ◽

M Cocchi ◽

...

Keyword(s):

Cardiac Surgery ◽

Length Of Stay ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Lactate Levels

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Predictors of extubation failure after open-chest cardiac surgery based on routinely collected data. The importance of a shared interprofessional clinical assessment

European Journal of Cardiovascular Nursing ◽

10.1177/1474515118782103 ◽

2018 ◽

Vol 17 (8) ◽

pp. 751-759 ◽

Cited By ~ 1

Author(s):

Gianfranco Sanson ◽

Massimiliano Sartori ◽

Lorella Dreas ◽

Roberta Ciraolo ◽

Adam Fabiani

Keyword(s):

Cardiac Surgery ◽

Length Of Stay ◽

Invasive Mechanical Ventilation ◽

Extubation Failure ◽

Hospital Length ◽

Neurological Function ◽

Hospital Length Of Stay ◽

Rapid Shallow Breathing Index ◽

Shallow Breathing ◽

Rapid Shallow Breathing

Background: Extubation failure (ExtF) is associated with prolonged hospital length of stay and mortality in adult cardiac surgery patients postoperatively. In this population, ExtF-related variables such as the arterial partial pressure of oxygen to fraction of inspired oxygen ratio (PaO2/FiO2), rapid shallow breathing index, cough strength, endotracheal secretions and neurological function have been sparsely researched. Aim: To identify variables that are predictive of ExtF and related outcomes. Method: Prospective observational longitudinal study. Consecutively presenting patients ( n=205) undergoing open-heart cardiac surgery and admitted to the Cardiosurgical Intensive Care Unit (CICU) were recruited. The clinical data were collected at CICU admission and immediately prior to extubation. ExtF was defined as the need to restart invasive or non-invasive mechanical ventilation while the patient was in the CICU. Results: The ExtF incidence was 13%. ExtF related significantly to hospital mortality, CICU length of stay and total hospital length of stay. The risk of ExtF decreased significantly, by 93% in patients with good neurological function and by 83% in those with a Rapid Shallow Breathing Index of ≥57 breaths/min per litre. Conversely, ExtF risk increased 27 times when the PaO2/FiO2 was <150 and 11 times when it was ≥450. Also, a reassuring PaO2/FiO2 value may hide critical pulmonary or extra-pulmonary conditions independent from alveolar function. Conclusion: The decision to extubate patients should be taken after thoroughly discussing and combining the data derived from nursing and medical clinical assessments. Extubation should be delayed until the patient achieves safe respiratory, oxygenation and haemodynamic conditions, and good neurocognitive function.

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