ABSTRACT
【Objective】 To analyze the profile of perioperative allogenic blood transfusion for single disease in patients who underwent spinal deformity correction surgery and risk factors of the blood transfusion, in order to provide reference for clinical decision making. 【Methods】 Clinical data from medical record homepage of 292 patients who underwent elective spinal deformity correction surgery at Chengdu Third People′s Hospital from January 2015 to December 2017 were retrospectively analyzed. Statistical analysis of the transfusion profile of allogeneic blood based on the type of single disease in patients undergoing correction surgery was performed. Multiple factor linear regression analysis was used to identify the risk factors of perioperative allogenic blood transfusion in patients with spinal deformity correction surgery. Hospital length of stay and discharge status were compared between transfusion group and non-transfusion group using Mann Whitney U test and chi-square test respectively. 【Results】 The year prevalence of perioperative allogeneic blood transfusion from 2015 to 2017 were 90.38%(47/52), 93.62%(44/47) and 81.35%(157/193), respectively. The prevalence of perioperative allogeneic blood transfusion in patients with kyphotic deformity in ankylosing spondylitis, kyphosis, adolescent idiopathic scoliosis, scoliosis and spinal stenosis were 89.08%(106/119)、79.49%(62/78)、95.24%(40/42)、84.38%(27/32) and 61.90%(13/21), respectively. Multivariate linear regression analysis showed that the regression coefficients for age and osteotomy were -0.060 (P<0.05) and 2.060 (P<0.05), respectively. Compared with non-transfusion group, the transfusion group had longer hospital length of stay (P<0.05). 【Conclusion】 Perioperative allogeneic blood transfusion in patients with spinal deformity correction surgery is closely related to the type of single disease. Age is a protective factor for perioperative allogeneic blood transfusion, while osteotomy is a risk factor for perioperative allogeneic blood transfusion in patients undergoing the spinal deformity correction surgery. Perioperative blood transfusion can also prolong the hospital length of stay of the patients.
ABSTRACT
Introduction: Cardiac surgery, owing to its invasiveness,need of anticoagulation, exposure to extracorporeal circulation(CPB) and relatively longer duration, is known to be associatedwith an increased risk of perioperative blood loss and allogeneicblood transfusions. Excessive bleeding requiring allogenicblood and blood components transfusion after cardiopulmonarybypass (CPB) is a common complication of cardiac surgeryimparting detrimental health and economic consequences.Many techniques like preoperative autologous blood collection(PAC), Acute normovolumic hemodilution (ANH), use ofminiaturized CPB circuit and use of ultrafiltration duringconduct of cardiopulmonary bypass (CPB) have been appliedin the past to conserve the blood during perioperative periodin cardiac surgery. Current study aimed to observe the efficacyof Tranexamic acid used during intraoperative period onpost-operative blood loss and requirement of allogenic bloodand blood products transfusion in cardiac surgical patientsrequiring cardiopulmonary bypass (CPB).Material and methods: 120 adult patients undergoingcardiac surgery requiring elective cardiopulmonary bypass(CPB) were categorized into 2 groups. Study (“TXA”) groupwas subjected to administration of tranexamic acid (20 mg/kg in divided doses). The 1st dose (10 mg/kg) was givenbefore initiation of CPB, 2nd dose (5 mg/kg) was given duringrewarming on CPB and 3rd dose (5 mg/kg) was given afterweaning off CPB along with protamine. The control (“NS”)group patients received normal saline as a placebo. Statisticalanalysis was done using “z test”.Results: “TXA” group had significantly lower post-operativebleeding and lesser requirement of allogenic blood and bloodproducts transfusion. The mean post-operative blood lossin “TXA” group was 427.42+/- 225.18 ml vs. 728.67+/-301.33ml in “NS” group. The mean PCV units transfused postoperatively in 72 hours in “TXA” group was 0.20+/-0.44 unitsvs. 0.67+/-0.60 in “NS” group. Patients in “TXA” group didnot require any FFP or platelets unit in contrast to “NS” groupwhere few patients required these products.Conclusion: The use of Tranexamic acid during intraoperative period in patient undergoing cardiac surgeryrequiring cardiopulmonary bypass circuit significantly reducesthe post-operative bleeding and requirement of allogenicblood and blood products transfusion.
ABSTRACT
PURPOSE: To compare the clinical outcomes of bilateral total knee arthroplasty (TKA) performed simultaneously by two teams or sequentially by one team under a single anesthesia, with those of staged bilateral TKA performed during separate hospitalizations. MATERIALS AND METHODS: We retrospectively analyzed 83 patients (166 knees) who underwent bilateral TKA. Group I comprised 25 patients receiving simultaneous bilateral TKA. Group II comprised 31 patients receiving sequential bilateral TKA. Group III comprised 27 patients receiving staged bilateral TKA spaced an average of 8.9 weeks apart. Data including complication rate, length of hospital stay, and allogenic blood transfusion rate were evaluated. RESULTS: Complication rate for group I, II, and III was 12%, 19.4%, and 25.9%, respectively, but there was no significant difference. Allogenic blood transfusion rate was 28%, 29%, and 11.1%, respectively, but there was no significant difference. The average hospital stay was 8.4 days, 8.9 days, and 14.5 days, respectively, and group I and II showed significantly shorter hospitalization compared with group III. CONCLUSION: Simultaneous or sequential bilateral TKA is a safe and efficient procedure that can shorten hospital stay without increasing complication rate and allogenic blood transfusion rate, compared with staged bilateral TKA.