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Comparative changes of pre-operative autologous transfusions and peri-operative cell salvage in the United States.

Publication ,  Journal Article
Goel, R; Petersen, MR; Patel, EU; Packman, Z; Bloch, EM; Gehrie, EA; Lokhandwala, PM; Ness, PM; Shaz, B; Katz, LM; Frank, SM; Tobian, AAR
Published in: Transfusion
October 2020

BACKGROUND: With improved safety of allogeneic blood supply, the use of preoperative autologous donations (PADs) and perioperative autologous cell salvage (PACS) has evolved. This study evaluated temporal trends in PAD and PACS use in the United States. METHODS: The National Inpatient Sample database, a stratified probability sample of 20% of hospitalizations in the United States, was used to compare temporal trends in hospitalizations reporting use of PADs and PACS from 1995 to 2015. Factors associated with their use were examined between 2012 and 2015 with use of multivariable Poisson regression. Sampling weights were applied to generate nationally representative estimates. RESULTS: There was a steady decrease in hospitalizations reporting PAD transfusions from 27.90 per 100 000 in 1995 to 1.48 per 100 000 hospitalizations in 2015 (P-trend <.001). In contrast, PACS increased from a rate of 1.16 per 100 000 in 1995 to peak of 20.51 per 100 000 hospitalizations in 2008 and then steadily declined (P-trend<.001). Higher odds of PACS and PADs were observed in older patients, elective procedures (vs urgent), and urban teaching/nonteaching hospitals (vs rural hospitals) (P < .001). PACS was more common in hospitalizations in patients with higher levels of severity of illness as compared to those with minor severity (adjusted prevalence ratio [adjPR], 2.39; 95% confidence interval [CI], 2.08-2.73; P<.001), while PADs were performed less often in patients with higher underlying severity of illness (All Patient Refined Diagnosis Related Groups, 4 vs 1, adjPR, 0.61; 95% CI, [0.39-0.95]; P = .028). CONCLUSIONS: There was a significant decrease in PAD red blood cell transfusions, while PACS has increased and subsequently decreased; PACS plays an important role in surgical blood conservation. The subsequent decline in PACS likely reflects further optimization of transfusion practice through patient blood management programs and improvement of surgical interventions.

Duke Scholars

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Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

October 2020

Volume

60

Issue

10

Start / End Page

2260 / 2271

Location

United States

Related Subject Headings

  • United States
  • Operative Blood Salvage
  • Middle Aged
  • Male
  • Humans
  • Hospitalization
  • Female
  • Erythrocyte Transfusion
  • Databases, Factual
  • Cardiovascular System & Hematology
 

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APA
Chicago
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MLA
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Goel, R., Petersen, M. R., Patel, E. U., Packman, Z., Bloch, E. M., Gehrie, E. A., … Tobian, A. A. R. (2020). Comparative changes of pre-operative autologous transfusions and peri-operative cell salvage in the United States. Transfusion, 60(10), 2260–2271. https://doi.org/10.1111/trf.15949
Goel, Ruchika, Molly R. Petersen, Eshan U. Patel, Zoe Packman, Evan M. Bloch, Eric A. Gehrie, Parvez M. Lokhandwala, et al. “Comparative changes of pre-operative autologous transfusions and peri-operative cell salvage in the United States.Transfusion 60, no. 10 (October 2020): 2260–71. https://doi.org/10.1111/trf.15949.
Goel R, Petersen MR, Patel EU, Packman Z, Bloch EM, Gehrie EA, et al. Comparative changes of pre-operative autologous transfusions and peri-operative cell salvage in the United States. Transfusion. 2020 Oct;60(10):2260–71.
Goel, Ruchika, et al. “Comparative changes of pre-operative autologous transfusions and peri-operative cell salvage in the United States.Transfusion, vol. 60, no. 10, Oct. 2020, pp. 2260–71. Pubmed, doi:10.1111/trf.15949.
Goel R, Petersen MR, Patel EU, Packman Z, Bloch EM, Gehrie EA, Lokhandwala PM, Ness PM, Shaz B, Katz LM, Frank SM, Tobian AAR. Comparative changes of pre-operative autologous transfusions and peri-operative cell salvage in the United States. Transfusion. 2020 Oct;60(10):2260–2271.
Journal cover image

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

October 2020

Volume

60

Issue

10

Start / End Page

2260 / 2271

Location

United States

Related Subject Headings

  • United States
  • Operative Blood Salvage
  • Middle Aged
  • Male
  • Humans
  • Hospitalization
  • Female
  • Erythrocyte Transfusion
  • Databases, Factual
  • Cardiovascular System & Hematology