The impact of comprehensive blood conservation program on major complications after total aortic arch replacement
Introduction Patients undergoing total aortic arch replacement (TAAR) usually require blood products perioperatively. This cohort study aimed to investigate the impact of a comprehensive blood conservation program on the major complications in these patients. Methods Patients with traditional or com...
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| Veröffentlicht in: | Perfusion 2024-04, Vol.39 (3), p.499-505 |
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| creator | Yan, Weidong Zhang, Qiaoni Gao, Sizhe Liu, Gang Teng, Yuan Wang, Jing Wang, Jian Zhou, Boyi Yan, Shujie Ji, Bingyang |
| description | Introduction
Patients undergoing total aortic arch replacement (TAAR) usually require blood products perioperatively. This cohort study aimed to investigate the impact of a comprehensive blood conservation program on the major complications in these patients.
Methods
Patients with traditional or comprehensive blood management intraoperatively from January 2017 to December 2018 were included. We compared the rates of major complications (cerebral vascular accident, acute kidney injury, or mortality) between the two groups after propensity score matching (PSM). The association between blood management and outcomes was assessed by logistic regression. Restricted cubic splines (RCS) were built to evaluate the impact of fresh frozen plasma (FFP) on complications. Patients were stratified by the ratio of FFP/RBC (red blood cell) to investigate the effect of the ratio on complications.
Results
After 1:1 PSM, 200 patients were selected. 35% (35/100) of patients suffered major complications in the traditional group, while it decreased to 22% (22/100) in the comprehensive management group (OR = 0.524, p = 0.043). Multivariable logistic regression showed that FFP was a risk factor (OR = 1.186, p = 0.014). RCS results indicated that with the increase of FFP, the risk of complications gradually increases. The cut-off value was 402 mL. Patients in the group of ratio = 0 ∼ 0.5 had a higher chance than those without transfusion (OR = 7.487, p < 0.001).
Conclusions
Comprehensive blood conservation program in patients undergoing TAAR is safe and can reduce the incidence of major complications, which are associated with FFP volume and the ratio of FFP/RBC. |
| doi_str_mv | 10.1177/02676591221147428 |
| format | Article |
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Patients undergoing total aortic arch replacement (TAAR) usually require blood products perioperatively. This cohort study aimed to investigate the impact of a comprehensive blood conservation program on the major complications in these patients.
Methods
Patients with traditional or comprehensive blood management intraoperatively from January 2017 to December 2018 were included. We compared the rates of major complications (cerebral vascular accident, acute kidney injury, or mortality) between the two groups after propensity score matching (PSM). The association between blood management and outcomes was assessed by logistic regression. Restricted cubic splines (RCS) were built to evaluate the impact of fresh frozen plasma (FFP) on complications. Patients were stratified by the ratio of FFP/RBC (red blood cell) to investigate the effect of the ratio on complications.
Results
After 1:1 PSM, 200 patients were selected. 35% (35/100) of patients suffered major complications in the traditional group, while it decreased to 22% (22/100) in the comprehensive management group (OR = 0.524, p = 0.043). Multivariable logistic regression showed that FFP was a risk factor (OR = 1.186, p = 0.014). RCS results indicated that with the increase of FFP, the risk of complications gradually increases. The cut-off value was 402 mL. Patients in the group of ratio = 0 ∼ 0.5 had a higher chance than those without transfusion (OR = 7.487, p < 0.001).
Conclusions
Comprehensive blood conservation program in patients undergoing TAAR is safe and can reduce the incidence of major complications, which are associated with FFP volume and the ratio of FFP/RBC.</description><identifier>ISSN: 0267-6591</identifier><identifier>ISSN: 1477-111X</identifier><identifier>EISSN: 1477-111X</identifier><identifier>DOI: 10.1177/02676591221147428</identifier><identifier>PMID: 36533906</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aorta ; Aorta, Thoracic - surgery ; Aortic arch ; Blood ; Blood Transfusion ; Cohort Studies ; Conservation ; Erythrocyte Transfusion ; Erythrocytes ; Humans ; Regression analysis ; Retrospective Studies ; Risk factors ; Stroke</subject><ispartof>Perfusion, 2024-04, Vol.39 (3), p.499-505</ispartof><rights>The Author(s) 2022</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c368t-9e7cd8aa90e39f850b16f87802c657106ff84a04731d34dae482747cb429d5fa3</citedby><cites>FETCH-LOGICAL-c368t-9e7cd8aa90e39f850b16f87802c657106ff84a04731d34dae482747cb429d5fa3</cites><orcidid>0000-0002-3753-9179</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/02676591221147428$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/02676591221147428$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36533906$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yan, Weidong</creatorcontrib><creatorcontrib>Zhang, Qiaoni</creatorcontrib><creatorcontrib>Gao, Sizhe</creatorcontrib><creatorcontrib>Liu, Gang</creatorcontrib><creatorcontrib>Teng, Yuan</creatorcontrib><creatorcontrib>Wang, Jing</creatorcontrib><creatorcontrib>Wang, Jian</creatorcontrib><creatorcontrib>Zhou, Boyi</creatorcontrib><creatorcontrib>Yan, Shujie</creatorcontrib><creatorcontrib>Ji, Bingyang</creatorcontrib><title>The impact of comprehensive blood conservation program on major complications after total aortic arch replacement</title><title>Perfusion</title><addtitle>Perfusion</addtitle><description>Introduction
Patients undergoing total aortic arch replacement (TAAR) usually require blood products perioperatively. This cohort study aimed to investigate the impact of a comprehensive blood conservation program on the major complications in these patients.
Methods
Patients with traditional or comprehensive blood management intraoperatively from January 2017 to December 2018 were included. We compared the rates of major complications (cerebral vascular accident, acute kidney injury, or mortality) between the two groups after propensity score matching (PSM). The association between blood management and outcomes was assessed by logistic regression. Restricted cubic splines (RCS) were built to evaluate the impact of fresh frozen plasma (FFP) on complications. Patients were stratified by the ratio of FFP/RBC (red blood cell) to investigate the effect of the ratio on complications.
Results
After 1:1 PSM, 200 patients were selected. 35% (35/100) of patients suffered major complications in the traditional group, while it decreased to 22% (22/100) in the comprehensive management group (OR = 0.524, p = 0.043). Multivariable logistic regression showed that FFP was a risk factor (OR = 1.186, p = 0.014). RCS results indicated that with the increase of FFP, the risk of complications gradually increases. The cut-off value was 402 mL. Patients in the group of ratio = 0 ∼ 0.5 had a higher chance than those without transfusion (OR = 7.487, p < 0.001).
Conclusions
Comprehensive blood conservation program in patients undergoing TAAR is safe and can reduce the incidence of major complications, which are associated with FFP volume and the ratio of FFP/RBC.</description><subject>Aorta</subject><subject>Aorta, Thoracic - surgery</subject><subject>Aortic arch</subject><subject>Blood</subject><subject>Blood Transfusion</subject><subject>Cohort Studies</subject><subject>Conservation</subject><subject>Erythrocyte Transfusion</subject><subject>Erythrocytes</subject><subject>Humans</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Stroke</subject><issn>0267-6591</issn><issn>1477-111X</issn><issn>1477-111X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1r3DAQhkVJabZpfkAvQZBLL071LfkYQvoBgV5S6M3MyqOsF9tyJG0g_z7abJpCS08aNM_7zjAvIR85u-Dc2s9MGGt0y4XgXFkl3BuyqoVtOOe_jshq32_2wDF5n_OWMaaUku_IsTRaypaZFbm_3SAdpgV8oTFQH6cl4QbnPDwgXY8x9vVvzpgeoAxxpkuKdwkmWssJtjE9K8bBP3czhVAw0RILjBRiKoOnkPyGJlxG8DjhXD6QtwHGjKcv7wn5-eX69upbc_Pj6_ery5vGS-NK06L1vQNoGco2OM3W3ARnHRPeaMuZCcEpYMpK3kvVAyonrLJ-rUTb6wDyhHw6-NaV73eYSzcN2eM4woxxlzthtXaMG80rev4Xuo27NNftOtFqa3m9r64UP1A-xZwThm5JwwTpseOs2-fR_ZNH1Zy9OO_WE_avit8BVODiAGS4wz9j_-_4BAPak2Q</recordid><startdate>202404</startdate><enddate>202404</enddate><creator>Yan, Weidong</creator><creator>Zhang, Qiaoni</creator><creator>Gao, Sizhe</creator><creator>Liu, Gang</creator><creator>Teng, Yuan</creator><creator>Wang, Jing</creator><creator>Wang, Jian</creator><creator>Zhou, Boyi</creator><creator>Yan, Shujie</creator><creator>Ji, Bingyang</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3753-9179</orcidid></search><sort><creationdate>202404</creationdate><title>The impact of comprehensive blood conservation program on major complications after total aortic arch replacement</title><author>Yan, Weidong ; Zhang, Qiaoni ; Gao, Sizhe ; Liu, Gang ; Teng, Yuan ; Wang, Jing ; Wang, Jian ; Zhou, Boyi ; Yan, Shujie ; Ji, Bingyang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c368t-9e7cd8aa90e39f850b16f87802c657106ff84a04731d34dae482747cb429d5fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aorta</topic><topic>Aorta, Thoracic - surgery</topic><topic>Aortic arch</topic><topic>Blood</topic><topic>Blood Transfusion</topic><topic>Cohort Studies</topic><topic>Conservation</topic><topic>Erythrocyte Transfusion</topic><topic>Erythrocytes</topic><topic>Humans</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Stroke</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yan, Weidong</creatorcontrib><creatorcontrib>Zhang, Qiaoni</creatorcontrib><creatorcontrib>Gao, Sizhe</creatorcontrib><creatorcontrib>Liu, Gang</creatorcontrib><creatorcontrib>Teng, Yuan</creatorcontrib><creatorcontrib>Wang, Jing</creatorcontrib><creatorcontrib>Wang, Jian</creatorcontrib><creatorcontrib>Zhou, Boyi</creatorcontrib><creatorcontrib>Yan, Shujie</creatorcontrib><creatorcontrib>Ji, Bingyang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Perfusion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yan, Weidong</au><au>Zhang, Qiaoni</au><au>Gao, Sizhe</au><au>Liu, Gang</au><au>Teng, Yuan</au><au>Wang, Jing</au><au>Wang, Jian</au><au>Zhou, Boyi</au><au>Yan, Shujie</au><au>Ji, Bingyang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of comprehensive blood conservation program on major complications after total aortic arch replacement</atitle><jtitle>Perfusion</jtitle><addtitle>Perfusion</addtitle><date>2024-04</date><risdate>2024</risdate><volume>39</volume><issue>3</issue><spage>499</spage><epage>505</epage><pages>499-505</pages><issn>0267-6591</issn><issn>1477-111X</issn><eissn>1477-111X</eissn><abstract>Introduction
Patients undergoing total aortic arch replacement (TAAR) usually require blood products perioperatively. This cohort study aimed to investigate the impact of a comprehensive blood conservation program on the major complications in these patients.
Methods
Patients with traditional or comprehensive blood management intraoperatively from January 2017 to December 2018 were included. We compared the rates of major complications (cerebral vascular accident, acute kidney injury, or mortality) between the two groups after propensity score matching (PSM). The association between blood management and outcomes was assessed by logistic regression. Restricted cubic splines (RCS) were built to evaluate the impact of fresh frozen plasma (FFP) on complications. Patients were stratified by the ratio of FFP/RBC (red blood cell) to investigate the effect of the ratio on complications.
Results
After 1:1 PSM, 200 patients were selected. 35% (35/100) of patients suffered major complications in the traditional group, while it decreased to 22% (22/100) in the comprehensive management group (OR = 0.524, p = 0.043). Multivariable logistic regression showed that FFP was a risk factor (OR = 1.186, p = 0.014). RCS results indicated that with the increase of FFP, the risk of complications gradually increases. The cut-off value was 402 mL. Patients in the group of ratio = 0 ∼ 0.5 had a higher chance than those without transfusion (OR = 7.487, p < 0.001).
Conclusions
Comprehensive blood conservation program in patients undergoing TAAR is safe and can reduce the incidence of major complications, which are associated with FFP volume and the ratio of FFP/RBC.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>36533906</pmid><doi>10.1177/02676591221147428</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3753-9179</orcidid></addata></record> |
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| source | MEDLINE; SAGE Complete |
| subjects | Aorta Aorta, Thoracic - surgery Aortic arch Blood Blood Transfusion Cohort Studies Conservation Erythrocyte Transfusion Erythrocytes Humans Regression analysis Retrospective Studies Risk factors Stroke |
| title | The impact of comprehensive blood conservation program on major complications after total aortic arch replacement |
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