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1.
Yoshiaki Furuta Yuki Nakamura Miho Tokida Kayoko Ichikawa Toshiya Ohsawa Mitsuo Ohkubo Akimichi Ohsaka 《Transfusion and apheresis science》2018,57(5):651-655
Objective
The objective of this study was to determine the rate of adverse reactions to pre-operative autologous blood donation (PAD) transfusion in a single institution over a 14-year period.Study design and methods
Between January 2003 and December 2016, we investigated adverse reactions to PAD transfusion and compared them with those to allogeneic blood transfusion in Juntendo University Hospital. Adverse reactions were categorized according to the definition proposed by the International Society of Blood Transfusion (ISBT) Working Party on Haemovigilance.Results
A total of 178,014 blood components were transfused during the study period, of which PAD transfusions were 13,653 (8%), whereas allogeneic blood transfusions were 164,361 (92%). The number and rate of adverse reactions to PAD transfusion were 16 and 0.1%, whereas those of allogeneic blood transfusion were 1075 and 0.7%, respectively. The rate of adverse reactions to allogeneic blood transfusions excluding platelet transfusion was 0.3%, being significant (p?<?0.01) against PAD transfusion. Among 16 adverse reactions to PAD transfusion, the most common was febrile non-hemolytic transfusion reaction (FNHTR) at 12 (75%), followed by allergic reaction at 4 (25%). The severity of adverse reactions to PAD transfusion was Grade 1 (non-severe) in all cases. With regard to blood component types, 16 adverse reactions involved: 12 cases of whole blood PAD, 2 of frozen PAD, and 2 of autologous fresh-frozen plasma.Conclusions
Non-severe adverse reactions were observed on PAD transfusion at a rate of 0.1% at our institution. 相似文献2.
Rong Zhang Zhao Wu Zongkui Wang Shengliang Ye Changqing Li Li Lu Ya Wang Shaoqin Rao 《Transfusion and apheresis science》2018,57(1):65-70
Objective
The safety and effectiveness of clinical transfusion are highly associated with clinical blood transfusion level. A survey was conducted with the aim of providing references to improve the level of clinical blood transfusion.Study design and methods
A survey was undertaken by means of a questionnaire which consisted of hospitals’ basic conditions, utilization of blood products and application of autologous blood transfusion in hospitals with scale, geographic and religious diversity in Sichuan, China. Data analysis was conducted in 3 groups according to the official classification of hospital.Results
76.8% (384/500) hospitals answered the questions completely. From 2011 to 2015, the usage of whole blood showed significant decreasing trend (P?=?0.047); in level 2 and level 3 hospitals, the used units of plasma and RBC were closely associated with the number of inpatient and operation (all r?≥?0.442; P?<?0.01). The plasma used per operation per year by level 3 hospitals and RBC used per inpatient per year by level 2 hospitals both showed a decreasing trend (P?=?0.047 and P?<?0.001); the plasma: RBC transfused by level 3 hospitals was higher than 1:1.8; the ABT rate was lower than 42.16% in all hospitals.Conclusions
The clinical blood transfusion level of hospitals in Sichuan, China has improved a lot in the past 5 years, but problems still existed, such as whole blood still being used, overuse of plasma and low ABT rate, and further work and improvements are needed to strengthen the management of clinical blood transfusion. 相似文献3.
Benjamin W. Dean Sarah N. Hewitt Morgan C. Begos Angela Gomez Locksley L. McV. Messam 《Transfusion and apheresis science》2018,57(1):40-45
Objectives
To estimate the associations of nationality, university program, donation history and gender, with blood donation barriers experienced by non-donating students on the day of a campus blood drive. This project focused particularly on nationality and the effect of the different blood donation cultures in the students' countries of origin.Methods
A retrospective cohort study of 398 North American and Caribbean university students was conducted at St. George's University, Grenada, in 2010. Data were collected from non-donating students on campus while a blood drive was taking place. Log-binomial regression was used to estimate associations between the exposures of interest and donation barriers experienced by the students.Results
North American (voluntary blood donation culture) students were more likely than Caribbean (replacement blood donation culture) students to experience “Lack of Time” (relative risk (RR)?=?1.57; 95% confidence interval (CI): 1.19–2.07) and “Lack of Eligibility” (RR?=?1.55; 95% CI: 1.08–2.22) as barriers to donation. Conversely, Caribbean students were a third as likely to state “Lack of Incentive” (RR?=?0.32; 95% CI: 0.20–0.50), “Fear of Infection” (RR?=?0.35; 95% CI: 0.21–0.58), and “Fear of Needles” (RR?=?0.32; 95% CI: 0.21–0.48) were barriers than North American students.Conclusions
University students from voluntary blood donation cultures are likely to experience different barriers to donation than those from replacement cultures. Knowledge of barriers that students from contrasting blood donation systems face provides valuable information for blood drive promotion in university student populations that contain multiple nationalities. 相似文献4.
A. Belsito D. Costa S. Signoriello C. Fiorito I. Tartaglione M. Casale S. Perrotta K. Magnussen C. Napoli 《Transfusion and apheresis science》2019,58(1):65-71
Background
The development of alloantibodies may complicate the management of patients with β-thalassemia. An extended antigenic matching may reduce the risk of alloimmunization. Our previous study showed that the introduction of molecular red blood cell (RBC) typing allows finding suitable blood units for multi-transfused patients. The aim of this study was to evaluate the benefit of RBC transfusion with extended antigenic match.Materials and methods
At the University of Campania “L. Vanvitelli”, we selected β-thalassemia major patients (age ≤23 years), without preformed alloantibodies. Data of patients receiving transfusion of leukoreduced RBC units for a period of one year with partial better match (PBM) including ABO, RhD, C/c, E/e, K/k antigens and consecutive one year with extended match (EM) including ABO, RhD, C/c, E/e, K/k, Fya/Fyb, Jka/Jkb, M/N, S/s antigens, were compared.Results
Eighteen patients, 8 males and 10 females with a mean age of 15.4 years (6.4 SD) received a mean number of 41.2 (6.0 SD) RBC units transfused with PBM and 41.8 (6.2 SD) with EM protocols. After two years of RBC transfusions with both antigen matching protocols, no new alloantibodies were developed in patients. No significant differences in Hb concentration and volume of RBC transfused were found between PBM and EM protocols.Conclusions
Thalassemia patients may benefit from receiving RBC transfusions based on extended antigen matching as demonstrated by the lack of new alloantibodies. However, our data show a high concordance between PBM and EM protocols considering pre-transfusion Hb, increment of Hb and volume of RBC transfused. 相似文献5.
William P. Sheffield Varsha Bhakta Craig Jenkins 《Transfusion and apheresis science》2018,57(6):768-772
Background
Plasma obtained via whole blood (WB) donation may be used either for transfusion or as recovered plasma (RP) for pooling and fractionation. In Canada, transfusable plasma must be processed within 24?h of phlebotomy, while the limit for RP processing is 72?h. We assessed the quality of RP produced by two WB processing methods and as a function of processing time.Study design and methods
RP units produced via the buffy coat method (BCM, n?=?26) or whole blood filtration (WBF, n?=?52) were tested for: the activities of prothrombin, fibrinogen, von Willebrand Factor (VWF), FV, FVII, and FVIII; the prothrombin time (PT); and total protein and IgG concentration. WBF RP units were evenly divided between those processed <48?h of phlebotomy (shorter-processed) or 48–72?h after phlebotomy (longer-processed).Results
WBF-RP did not differ significantly from BCM-RP in any tested parameter except for FV and FVIII, which exhibited mean reductions of 10.2% and 20%, respectively. Longer-processed WBF-RP did not differ significantly from shorter-processed WBF-RP in any tested parameter except for FVIII activity and IgG concentration, which exhibited mean reductions of 30.1% and 14.3%, respectively.Conclusions
Canadian RP is currently fractionated into IgG, albumin, fibrinogen, and FVII/VWF concentrates irrespective of its method or time of processing. Our results supported the current approach of fractionating both BCM- and WBF-derived RP, but suggest that greater yields of immunoglobulin and FVIII/VWF products could be obtained if the maximum processing time was reduced from 72?h to 48?h. 相似文献6.
Objective
To compare clinical pain intensity, exercise performance, pain sensitivity and the effect of aerobic and isometric exercise on local and remote pressure pain thresholds (PPTs) in patients with chronic musculoskeletal pain with high and low levels of kinesiophobia.Design
An experimental pre–post within-subject study.Setting
An exercise laboratory in a multidisciplinary pain clinic.Participants
Fifty-four patients with chronic musculoskeletal pain.Interventions
Acute aerobic and isometric leg exercises.Main outcome measures
Clinical pain intensity (numerical rating scale, range 0 to 10), Tampa Scale of Kinesiophobia, aerobic and isometric exercise performances (intensity and maximal voluntary contraction), and PPTs at local and remote body areas before and after exercise conditions.Results
Patients with a high degree of kinesiophobia demonstrated increased pain intensity compared with patients with a low degree of kinesiophobia [high degree of kinesiophobia: 7.3 (1.6) on NRS; low degree of kinesiophobia: 6.3 (1.6) on NRS; mean difference 1.0 (95% confidence interval 0.08 to 1.9) on NRS]. Aerobic and isometric exercises increased PPTs, but no significant group differences were found in PPTs before and after exercise.Conclusions
Clinical pain intensity was significantly higher in patients with a high degree of kinesiophobia compared with patients with a low degree of kinesiophobia. Despite a difference in isometric exercise performance, the hypoalgesic responses after cycling and isometric knee exercise were comparable between patients with high and low degrees of kinesiophobia. If replicated in larger studies, these findings indicate that although kinesiophobic beliefs influence pain intensity, they do not significantly influence PPTs and exercise-induced hypoalgesia in patients with chronic musculoskeletal pain. 相似文献7.
8.
Andreea-Iuliana Ceanga Mihai Ceanga Maria Eveslage Edwin Herrmann Dania Fischer Axel Haferkamp Maria Wittmann Stefan Müller Hugo Van Aken Andrea Ulrike Steinbicker 《Transfusion and apheresis science》2018,57(6):739-745
Background
Preoperative anemia and allogeneic blood transfusions (ABTs) may affect outcomes in cancer surgery. The prevalence of anemia, the use of ABTs, the risks of transfusions, lengths of stay and mortality of oncological patients undergoing radical cystectomy were investigated in three University Hospitals in Germany.Patients and Methods
Hospital records of 220 consecutive patients undergoing radical cystectomy from 2010 to 2012 were retrospectively analyzed for independent risk factors of ABT and unfavorable outcomes (readmission, increased length of stay (LOS) or death) using multivariate regression analysis.Results
Preoperative anemia was present in 40%. 70% of patients received blood transfusions. Low preoperative and intraoperative nadir hemoglobin levels were associated with receipt of ABT (OR 1.33, P?=?0.04 and OR 2.94, P?<?0.001 respectively). Transfusion of ten or more red blood cell units (RBCs) during the entire hospital stay was a predictor of an increased LOS (P?<?0.001) and death (OR 52, 95%CI [5.9, 461.3], P?<?0.001), compared to non-transfused patients. Preoperative ABT and ASA scores were associated with ≥10RBCs.Conclusion
Anemic patients undergoing radical cystectomy had a high risk to receive ABTs. Preoperative transfusions and transfusion of ≥10RBCs during the entire hospital stay may increase patient`s mortality.Prospective, randomized controlled studies have to follow this study. 相似文献9.
Matthew S. Karafin Erica Carpenter Amy Pan Pippa Simpson Joshua J. Field 《Transfusion and apheresis science》2017,56(3):345-351
Background
In adults with sickle cell disease (SCD), the effects of the red cell storage lesion are not well defined. The objectives of this study were to: (1) describe the distribution of storage ages provided to adults with SCD, and (2) evaluate clinical outcomes associated with storage age.Patients and methods
We performed a retrospective cohort study of adults with SCD managed with prophylactic simple transfusion regimens. Units were universally pre-storage leukocyte reduced and CEK-matched. Age of the unit was 42 days minus the difference between the expiration and transfusion dates. A mixed effects model, which accounts for a subject's contribution to repeated transfusion encounters, was used to investigate the association between storage age and the incidence of hospital encounters for infection and pain crises prior to the next red cell transfusion.Results
Over the study interval, twenty-eight steady-state adults with SCD received 627 units via simple transfusion over 281 outpatient encounters. Overall median unit storage age was 22 days (range: 2–42 days). Receipt of older units was associated with an increased incidence of emergency department or hospital admission for infection prior to the next transfusion (p = 0.04). There was no association between unit storage age and admission for pain (p = 0.4).Discussion
In a cohort of chronically transfused adults with SCD, we provide evidence that receipt of older units is associated with a higher rate of admission for infection. Prospective studies will need to validate these data and explore potential mechanisms by which these older units promote infection. 相似文献10.
Objectives
The present study was aimed to find out the prevalence of parvovirus B19? amongst healthy blood donors and blood transfusion recipients so as to determine the feasibility of providing seronegative blood components to vulnerable recipients.Methods
A total of 1000 samples were studied which included 800 blood donors and 200 transfusion recipients.The transfusion recipients included 100 multitransfused patients and 100 non transfused controls.All samples were subjected to parvovirus B19 ELISA for IgG and IgM antibodies.Results
Of the 800 blood donors,663(82.9%) were voluntary while 137(17.1%) were replacement donors.The seroprevalence of B19V IgG antibodies among healthy blood donors was found to be 34.1% whilst that of IgM antibodies was 1.4%.The seroprevalence of B19?V IgG antibodies was found to be 28.4% in the age group 18–35 years and 42.1% in donors more than 35 years of age(p?≤?0.01). The overall seroprevalence of IgG antibodies in multitransfused patients was 34% and IgM antibodies was 7.0%.The B19?V IgG prevalence was 20% in the transfused patients aged 0–20 years and 48% in patients above 20 years of age (p?≤?0.05).Conclusion
The moderately high seroprevalence of B19 V IgG in blood donors and patients suggests endemicity of infection.However, prevalence of B19?V IgM antibodies in blood donors is low.With the widespread use of pooled plasma derived medicinal products and recognition of severe pathological effects in susceptible recipients, transfusion transmission of B19?V has become a major concern in the past few decades.We suggest screening of blood units to identify B19?V IgM negative units for transfusion to selected patients. 相似文献11.
Shin-ichiro Fujiwara Naohito Fujishima Heiwa Kanamori Masumi Ito Tatsuya Sugimoto Shoko Saito Takeshi Sakaguchi Koichi Nagai Hidekazu Masuoka Kazuhiro Nagai Akie Morita Shuichi Kino Asashi Tanaka Yuichi Hasegawa Akihiko Yokohama Keizo Fujino Shigeyoshi Makino Mayumi Matsumoto Kazuo Muroi 《Transfusion and apheresis science》2018,57(6):746-751
Background
Plasma removal by washing is an effective approach to prevent transfusion reactions by platelet concentrates (PCs). Recently, washed PCs were released by the Japanese Red Cross Society (JRCS).Materials and methods
This retrospective multicenter study evaluated the efficacy and safety of released washed PCs (RWPCs) between September 2016 and January 2017 in Japan. The RWPCs were prepared by washing leukoreduced apheresis PCs with the platelet additive solution, BRS-A, using automated cell processors.Results
Clinical data were obtained from 91 patients and 1210 RWPC transfusions at 50 institutions. The median number of RWPC transfusions per patient was 8 (range, 1–91). RWPCs were used in 94.5% of the patients with a history of recurrent or severe transfusion reactions for preventing such reactions. Responses of RWPCs were evaluated as complete response (91.6%), partial response (8.2%), no-change (0.2%), and progression (0%) and overall response was equal across subgroups divided by patients’ profiles. The median corrected count increment (CCI) at 1 and 24?h post-transfusion were 13.5 (range, 1.9–35.4)?×?109/L and 3.5 (range, ?13 to 53.6)?×?109/L, respectively, and median CCI at 24?h was 5.5 (range, ?13 to 53.6)?×?109/L in patients without risk factors associated with platelet transfusion refractoriness. Transfusion reactions to RWPCs were observed in only nine transfusions (0.7%), all of which were mild allergic reactions.Conclusion
This study demonstrated that RWPCs were effective and safe in patients with a history of transfusion reactions. Further prospective studies on efficacy together with cost-benefit analysis in RWPCs are needed. 相似文献12.
Li-xin Jiao Jiang-hong Yu Xiao-li Yu Lin Chen Yu Han Fan Yang 《Transfusion and apheresis science》2017,56(2):223-225
Objective
To identify the precise ABO blood type subgroups with genotyping.Method
We screened ABO blood type from voluntary blood donors in our blood collection center. Samples were first examined with a routine serological method. Samples with ambiguous results were further examined with genotyping to identify ABO subgroups.Results
Two samples identified as AweakB by serology were considered to be A/B and B/B by PCR-SSP. However, the gene sequencing results revealed the precise subgroup to be CisAB01/B101 and CisAB05/B101, respectively.Conclusion
It may be difficult to identify non-typical AB patients with a routine serological method. Genotyping is a more precise method to identify blood subgroups. 相似文献13.
Amaris M. Keiser Garrett S. Booth Eric A. Gehrie 《Transfusion and apheresis science》2018,57(2):250-252
Objectives
Automated red blood cell exchange (RBX) is an important treatment for patients with sickle cell disease (SCD). Although not specifically targeted for removal, platelets (PLTs) are collected along with red blood cells during RBX. We sought to determine whether the pre- and post- RBX PLT counts could be used to derive the post-procedure hemoglobin S% (HgbS%).Methods
Using the pre- and post- RBX lab values of 59 SCD patients undergoing 112 RBX procedures over 1?year, we derived mathematical formulas which estimate the post-RBX HgbS% based on the pre-RBX HgbS%, the pre- and post- RBX PLT, and a correction factor.Results
For patients with pre-RBX HgbS >?40%, the mathematically derived post-RBX HgbS% was statistically indistinguishable from the measured post-RBX HgbS%.Conclusions
Using a simple formula, pre- and post-RBX platelet counts can provide a rapid approximation of the measured post-RBX HgbS% in patients with SCD. 相似文献14.
Calvin Diep Andrew W. Shih Erin Jamula Nancy M. Heddle Michael Parvizian Christopher M. Hillis 《Transfusion and apheresis science》2018,57(2):215-221
Background
With increasing global use of intravenous immunoglobulin (IVIG), there is interest in its appropriate usage. Efforts to regulate IVIG usage have primarily taken the form of organizational interventions implemented in hospitals to monitor and improve physician prescribing. Similar interventions have proven effective in reducing the inappropriate and total hospital usage of other blood products, but their efficacy on IVIG use is less understood. Thus, we performed a systematic review of studies reporting the change in inappropriate IVIG use following such interventions in hospitals or regions.Methods
A systematic search was carried out using MEDLINE and EMBASE (1966-June 2016) for English language studies if they 1) were primary research, 2) described an organizational intervention to target plasma, IVIG, or albumin, and 3) reported appropriateness of usage and total usage preand post-intervention. Review Manager v5.0 was utilized to perform a random-effects meta-analysis on eligible IVIG studies, where the risk ratio (RR) of inappropriate IVIG transfusion comparing pre- and postintervention periods was calculated with 95% confidence intervals (CI).Results
Our search retrieved three retrospective cohort studies, where metaanalysis encompassing 2100 episodes of IVIG transfusion demonstrated no decrease in inappropriate IVIG use (RR 1.55, 95% CI 0.78–3.07). Heterogeneity between studies was considerable (I2?=?89%).Conclusion
Organizational interventions were ineffective at changing inappropriate IVIG use, but more high-quality studies describing the effects of these interventions are required before any conclusions can be drawn. Futureresearch efforts should also be directed at evolving evidence-based IVIGguidelines to improve patient safety and burdens on healthcare systems 相似文献15.
Rafiye Ciftciler Haluk Demiroglu Yahya Buyukasık Mufide Okay Salih Aksu Nilgun Sayınalp Umit Yavuz Malkan Ibrahim Celalettin Haznedaroglu Osman Ozcebe Hakan Goker 《Transfusion and apheresis science》2018,57(6):752-755
Background and Aim
This is a retrospective study aiming to investigate the effect of the number of high dose cytarabine-based chemotherapy (HiDAC) courses in patients with acute myeloid leukemia before allogenic stem cell transplantation (ASCT).Materials and Methods
A total of 110 patients with acute myeloid leukemia who received ASCT between 2001 and 2018 were included in the study.Results
Of the 110 patients, 25 (23%) patients received one course of HiDAC, 42 (38%) patients received two courses of HiDAC, 34 (31%) patients received three courses of HiDAC and 9 (8%) patients received four courses of HiDAC. Median follow-up for survivors was 71 months (range 4–186) for all patients. The 3-year overall survival for patients who received one course of HiDAC and patients who received more than one course of HiDAC were 49% and 70%, respectively (p?=?0.29). The 3-year disease free survival (DFS) for patients who received one course of HiDAC and patients who received more than one course of HiDAC were 38% and 66%, respectively (p?=?0.05). There was no statistically significant difference in OS between patients who received one or more than one consolidation chemotherapy. But there was nearly a statistically significant difference between patients who received one or more than one consolidation chemotherapy in DFS.Conclusion
In conclusion, the administration of more than one consolidation chemotherapy may provide longer DFS, however the number of consolidation chemotherapy is not associated with statistically significant differences in overall outcomes. 相似文献16.
Objective
To estimate the effectiveness of a 10-week combined exercise training and home-based walking programme on daily physical activity (PA) compared with standard medical care in patients with moderate chronic obstructive pulmonary disease (COPD).Design
Randomised controlled trial.Setting
Primary care physiotherapy.Participants
Consecutive patients with stable COPD at Gold Stage II with a score of two or more on the Medical Research Council Dyspnoea Scale.Intervention
Ten-week combined exercise training and home-based walking programme compared with standard medical care.Main outcomes
At baseline and after 10 weeks, daily PA was evaluated by accelerometry using three levels of intensity and expressed as metabolic equivalent of task. In addition, daily activities (Physical Activity Scale for the Elderly), functional exercise capacity (6-minute Walk Test), health-related quality of life (Chronic Respiratory Questionnaire) and exercise self-efficacy (Exercise Self-Regulatory Efficacy Scale) were measured.Results
Fifty-two patients {34 females; mean age 70.2 [standard deviation (SD) 9.5] years; mean forced expiratory volume in 1 second 67% (SD 9.2) of predicted} were randomised. PA, adjusted for baseline differences, increased significantly in the intervention group compared with the control group, by 26.1 minutes/day [95% confidence interval (CI) 7.3 to 44.9]. The increase in functional capacity between groups was clinically relevant (34.0 m, 95% CI 2.3 to 65.6) in favour of the intervention group.Conclusions
A combined exercise training and home-based walking programme in primary care physiotherapy improved PA in patients with moderate COPD.Clinical trial registration number NL24766.018.08. 相似文献17.
Effects of exercise training in water and on land in patients with COPD: a randomised clinical trial
J.M. Felcar V.S. Probst D.R. de Carvalho M.F. Merli R. Mesquita L.S. Vidotto L.R.G. Ribeiro F. Pitta 《Physiotherapy》2018,104(4):408-416
Objectives
To compare the effects of two similar 6-month protocols of high-intensity exercise training, in water and on land, in patients with chronic obstructive pulmonary disease (COPD).Design
Randomised controlled trial.Setting
University-based outpatient clinic.Participants
Thirty-six patients with predominantly moderate-to-severe COPD completed the study.Intervention
Patients were evaluated at baseline, at 3 months and at the end of the programme (i.e. 6 months). For both groups, the 6-month protocol consisted of high-intensity endurance and strength exercises with gradual increase in time and/or workload, totalling 60 sessions.Main outcomes
Objective monitoring of physical activity in daily life (PADL, primary outcome), lung function, peripheral and respiratory muscle strength, body composition, maximal and submaximal exercise capacity, functional status, quality of life, and symptoms of anxiety and depression.Results
After 6 months of training, a significant improvement in PADL was seen for both groups [mean difference (95% confidence interval): land group 993 (358 to 1628) steps/day; water group 1669 (404 to 2934) steps/day]. Significant improvements were also seen in inspiratory, expiratory and peripheral muscle strength; maximal and submaximal exercise capacity; quality of life and functional status for both groups. There were no significant improvements in lung function, body composition, and symptoms of anxiety and depression for either group. No difference was found in the magnitude of improvement between the two types of training for any outcome.Conclusion
High-intensity exercise training in water generates similar effects compared with training on land in patients with moderate-to-severe COPD, rendering it an equally beneficial therapeutic option for this population.Clinical trial registration number
NCT01691131. 相似文献18.
Objectives
To establish the relationship between the use of home non-invasive ventilation (NIV) and inhospital mortality in people admitted due to exacerbation of their respiratory disease.Methods
Retrospective cohort study with 191 cases of patients attended at the emergency department of the Reina Sofía General University Hospital in Murcia due to ARF of any cause and who required NIV as supportive treatment.Results
Mortality among patients using NIV as routine home treatment was 6.45%, compared to 20.1% among those who did not use it (P < .05).Conclusions
routine domiciliary treatment with NIV has been shown to be a protective factor against inpatient hospital mortality for patients who underwent NIV during their admission, through the emergency department, for acute respiratory failure or acute chronic disease, regardless of the triggering pathology. 相似文献19.
Carlo Trevisan Raymond Klumpp Laura Auriemma Riccardo Compagnoni 《Transfusion and apheresis science》2018,57(2):272-276
Introduction
Patients receiving blood transfusions after total hip arthroplasty have increased morbidity and longer lengths of stay compared to non-transfused patients. The aim of this study is to create an algorithm in order to identify patients at risk for transfusion after total hip replacement and define a safe point in hemoglobin levels after which the need for blood, transfusion can be excluded.Methods
This retrospective study analyzed hemoglobin (Hb) levels for 5?days in patients undergoing total hip replacement. An algorithm was implemented to identify the critical trends of Hb levels in the first two postoperative days, trying to identify the patients at high risk of transfusion. Specificity, sensibility and efficiency were calculated in relation to the capability of the algorithm to correctly identify transfused patients.Results
The algorithm found a pre-operative Hb?≥?13?g/dl as a cut off between patients at low-risk or high-risk for transfusion. When parameters were calculated considering the best efficiency with the least number of false negatives, the algorithm showed a specificity of 84% and a sensitivity of 70% with an efficiency of 80.6%. Hb values?>10?g/dl in the first operative day for low-risk patients and Hb level?>?11?g/dl the second post-operative day for high-risk patients led to exclusion of the need for transfusion.Conclusions
The algorithm suggested critical Hb levels to predict transfusion. In association with clinical data, the suggested critical values of Hb may be useful to schedule lab tests and a safe early discharge. 相似文献20.