Idioma:

Trends in red blood cell transfusion and 30-day mortality among hospitalized patients

Roubinian, Nareg H. ; Escobar, Gabriel J. ; Liu, Vincent ; Swain, Bix E. ; Gardner, Marla N. ; Kipnis, Patricia ; Triulzi, Darrell J. ; Gottschall, Jerome L. ; Wu, Yan ; Carson, Jeffrey L. ; Kleinman, Steven H. ; Murphy, Edward L.

Transfusion (Philadelphia, Pa.), 2014-10, Vol.54 (10pt2), p.2678-2686 [Periódico revisado por pares]

Hoboken, NJ: Blackwell Publishing Ltd

Texto completo disponível

Citações Citado por

Enviar para

Título:
Trends in red blood cell transfusion and 30-day mortality among hospitalized patients
Autor: Roubinian, Nareg H. ; Escobar, Gabriel J. ; Liu, Vincent ; Swain, Bix E. ; Gardner, Marla N. ; Kipnis, Patricia ; Triulzi, Darrell J. ; Gottschall, Jerome L. ; Wu, Yan ; Carson, Jeffrey L. ; Kleinman, Steven H. ; Murphy, Edward L.
Assuntos: Aged ; Aged, 80 and over ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis ; Bloodless Medical and Surgical Procedures - statistics & numerical data ; Comorbidity ; Erythrocyte Transfusion - trends ; Erythrocyte Transfusion - utilization ; Female ; Hemoglobins ; Hospital Mortality ; Hospitalization - statistics & numerical data ; Humans ; Incidence ; Inpatients - statistics & numerical data ; Length of Stay - statistics & numerical data ; Male ; Managed Care Programs - statistics & numerical data ; Medical sciences ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Risk Adjustment ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
É parte de: Transfusion (Philadelphia, Pa.), 2014-10, Vol.54 (10pt2), p.2678-2686
Notas: ark:/67375/WNG-CBGB2VF4-X
Fig. S1. RBC transfusion guidelines within KPNC. Fig. S2. Clinician decision support as part of computerized order entry for RBC transfusion in electronic medical record. Fig. S3. RBC utilization in inpatients and outpatients across 21 KPNC facilities by month and year. Fig. S4. RBC transfusion incidence for medical and surgical admission conditions. Methods S1. Audit of KPNC blood product record. Methods S2. Grouping of HCUP codes into admission conditions. Methods S3. Grouping of HCUP codes into subgroup conditions.
ArticleID:TRF12825
istex:38625E9765ACF0E24F21B398AA8AE14F121BB8A5
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
E.L. Murphy and E.W. Fiebig, University of California, San Francisco (UCSF), San Francisco, CA
The NHLBI Recipient Epidemiology Donor Evaluation Study - III (REDS-III), domestic component, is the responsibility of the following persons
Steering Committee Chairman: S. H. Kleinman, University of British Columbia, Victoria, BC, Canada
National Heart, Lung, and Blood Institute, National Institutes of Health: S. A. Glynn and A.M. Cristman
Central laboratory: M.P. Busch and P.J. Norris, Blood Systems Research Institute, San Francisco, CA
Publication Committee Chairman: R. Y. Dodd, American Red Cross, Holland Laboratory, Rockville, MD
E.L. Snyder, Yale University School of Medicine, New Haven, CT and R.G Cable, American Red Cross Blood Services, Farmington CT
Data coordinating center: D. J. Brambilla and M. T. Sullivan, RTI International, Rockville, MD
Hubs: A.E. Mast and J.L. Gottschall, BloodCenter of Wisconsin (BCW), Milwaukee, WI
D.J. Triulzi and J.E. Kiss, The Institute For Transfusion Medicine (ITXM), Pittsburgh, PA
Descrição: Background Blood conservation strategies have been shown to be effective in decreasing red blood cell (RBC) utilization in specific patient groups. However, few data exist describing the extent of RBC transfusion reduction or their impact on transfusion practice and mortality in a diverse inpatient population. Study Design and Methods We conducted a retrospective cohort study using comprehensive electronic medical record data from 21 medical facilities in Kaiser Permanente Northern California. We examined unadjusted and risk‐adjusted RBC transfusion and 30‐day mortality coincident with implementation of RBC conservation strategies. Results The inpatient study cohort included 391,958 patients who experienced 685,753 hospitalizations. From 2009 to 2013, the incidence of RBC transfusion decreased from 14.0% to 10.8% of hospitalizations; this change coincided with a decline in pretransfusion hemoglobin (Hb) levels from 8.1 to 7.6 g/dL. Decreased RBC utilization affected broad groups of admission diagnoses and was most pronounced in patients with a nadir Hb level between 8 and 9 g/dL (n = 73,057; 50.8% to 19.3%). During the study period, the standard deviation of risk‐adjusted RBC transfusion incidence across hospitals decreased by 44% (p < 0.001). Thirty‐day mortality did not change significantly with declines in RBC utilization in patient groups previously studied in clinical trials nor in other subgroups. Conclusions After the implementation of blood conservation strategies, RBC transfusion incidence and pretransfusion Hb levels decreased broadly across medical and surgical patients. Variation in RBC transfusion incidence across hospitals decreased from 2010 to 2013. Consistent with clinical trial data, more restrictive transfusion practice did not appear to impact 30‐day mortality.
Editor: Hoboken, NJ: Blackwell Publishing Ltd
Idioma: Inglês

Links

Voltar para lista de resultados

Realização: Logos de Redes Sociais:

Trends in red blood cell transfusion and 30-day mortality among hospitalized patients

Roubinian, Nareg H. ; Escobar, Gabriel J. ; Liu, Vincent ; Swain, Bix E. ; Gardner, Marla N. ; Kipnis, Patricia ; Triulzi, Darrell J. ; Gottschall, Jerome L. ; Wu, Yan ; Carson, Jeffrey L. ; Kleinman, Steven H. ; Murphy, Edward L.

Hoboken, NJ: Blackwell Publishing Ltd

Buscando em bases de dados remotas. Favor aguardar.