The impact of a multidisciplinary blood conservation protocol on patient outcomes and cost after cardiac surgery Niv Ad, MD, Sari D. Holmes, PhD, Jay.

Slides:

Advertisements

Similar presentations

Blood lactate level during extracorporeal life support as a surrogate marker for survival Sung Jun Park, MD, Sang-pil Kim, MD, PhD, Joon Bum Kim, MD,

Advertisements

Previous coronary stents do not increase early and long-term adverse outcomes in patients undergoing off-pump coronary artery bypass grafting: A propensity-matched.

Benefits and risks of using clopidogrel before coronary artery bypass surgery: Systematic review and meta-analysis of randomized trials and observational.

Influence of diabetes on survival in patients with cystic fibrosis before and after lung transplantation Don Hayes, MD, MS, Alpa V. Patel, MD, Sylvester.

Factors associated with postoperative atrial fibrillation and other adverse events after cardiac surgery Emmanuel Akintoye, MD, MPH, Frank Sellke, MD,

Two decades of pediatric lung transplant in the United States: Have we improved? Farhan Zafar, MD, Jeffrey S. Heinle, MD, Marc G. Schecter, MD, Joseph.

Pre-existing psychological depression confers increased risk of adverse cardiovascular outcomes following cardiac surgery: A systematic review and meta-analysis

Platelet-rich plasmapheresis in cardiac surgery: A meta-analysis of the effect on transfusion requirements F.D. Rubens, MDa, D. Fergusson, MHAb, P.S.

Niv Ad, MD, Linda Henry, PhD, RN, Deborah J. Shuman, BS, Sari D

The impact of placing multiple grafts to each myocardial territory on long-term survival after coronary artery bypass grafting Danny Chu, MD, Faisal.

Niv Ad, MD, Rakesh M. Suri, MD, DPhil, James S

The persistent problem of new-onset postoperative atrial fibrillation: A single-institution experience over two decades Jeanne Shen, BS, Shelly Lall,

Outcomes of coronary artery bypass grafting in patients with inflammatory rheumatic diseases: An 11-year nationwide cohort study Chao-Han Lai, MD, PhD,

Should asymptomatic patients discharged with lower hemoglobin expect worse outcomes after valve surgery? Niv Ad, MD, Sari D. Holmes, PhD, Deborah J.

Amiodarone after surgical ablation for atrial fibrillation: Is it really necessary? A prospective randomized controlled trial Niv Ad, MD, Sari D. Holmes,

Presurgical levels of circulating cell-derived microparticles discriminate between patients with and without transfusion in coronary artery bypass graft.

Puja Gaur, MD, Tsuyoshi Kaneko, MD, Siobhan McGurk, BS, James D

Stenting versus coronary artery bypass grafting for unprotected left main coronary artery disease: A meta-analysis of comparative studies Hisato Takagi,

The least of 3 evils: Exposure to red blood cell transfusion, anemia, or both? Gabriel Loor, MD, Jeevanantham Rajeswaran, PhD, Liang Li, PhD, Joseph F.

CD133+ cells: How could they have an IMPACT?

Comparison of EuroSCORE II, Original EuroSCORE, and The Society of Thoracic Surgeons Risk Score in Cardiac Surgery Patients Niv Ad, MD, Sari D. Holmes,

Effect of duration of red blood cell storage on early and late mortality after coronary artery bypass grafting Albert H.M. van Straten, MD, Mohamed A.

Blood lactate level during extracorporeal life support as a surrogate marker for survival Sung Jun Park, MD, Sang-pil Kim, MD, PhD, Joon Bum Kim, MD,

The impact of acute kidney injury on midterm outcomes after coronary artery bypass graft surgery: A matched propensity score analysis Sean Gallagher,

Influence of diabetes on survival in patients with cystic fibrosis before and after lung transplantation Don Hayes, MD, MS, Alpa V. Patel, MD, Sylvester.

Lower graft patency after off-pump than on-pump coronary artery bypass grafting: An updated meta-analysis of randomized trials Hisato Takagi, MD, PhD,

Defining operative mortality: Impact on outcome reporting

Zhe Zheng, MD, PhD, Heng Zhang, MD, PhD, Bo Xu, MBBS

Linda Henry, PhD, RN, Linda Halpin, MSN, RN, Sharon Hunt, MBA, Sari D

Strict versus liberal target range for perioperative glucose in patients undergoing coronary artery bypass grafting: A prospective randomized controlled.

Off-pump versus on-pump coronary artery bypass grafting: A systematic review and meta-analysis of propensity score analyses Oliver Kuss, PhD, Benita.

Multilevel data analysis: What? Why? How?

Harold L. Lazar, MD The Journal of Thoracic and Cardiovascular Surgery

Predictors of contemporary coronary artery bypass grafting outcomes

Mixed venous oxygen saturation predicts short- and long-term outcome after coronary artery bypass grafting surgery: a retrospective cohort analysis J.

Quality of life outcomes are equivalent after lobectomy in the elderly

Transfusion of sex-mismatched and non–leukocyte-depleted red blood cells in cardiac surgery increases mortality Henrik Bjursten, MD, PhD, Alain Dardashti,

Surgical economics: MACRA, MIPS, and bundles—Lessons learned in the first 3 years of a coronary artery bypass grafting alternative payment model Daniel.

Optimal timing of coronary artery bypass after acute myocardial infarction: A review of California discharge data Eric S. Weiss, MD, David D. Chang,

A decade after the Surgical Treatment for Ischemic Heart Failure (STICH) trial: Weaving firm clinical recommendations from lessons learned Robert E.

Left-Sided Surgical Ablation for Patients With Atrial Fibrillation Who Are Undergoing Concomitant Cardiac Surgical Procedures Niv Ad, MD, Sari D. Holmes,

The effect of coronary artery bypass grafting on specific causes of long-term mortality in the Bypass Angioplasty Revascularization Investigation David.

Who needs blood? The flip side of blood conservation

Zoe K. McQuilten, MBBS, Nick Andrianopoulos, MBBS, MBiostat, Erica M

Nishant Saran, MBBS, Sameh M. Said, MD, Hartzell V

Performance of the European System for Cardiac Operative Risk Evaluation II: A meta- analysis of 22 studies involving 145,592 cardiac surgery procedures

Michael Mack, MD, David Taggart, MD

For everything there is a season

Niv Ad, MD, Sari D. Holmes, PhD, Paul S. Massimiano, MD, Anthony J

Arterial lactate before initiation of venoarterial extracorporeal membrane oxygenation for postcardiotomy shock improves postimplant outcome prediction

Do we increase the operative risk by adding the Cox Maze III procedure to aortic valve replacement and coronary artery bypass surgery? Niv Ad, MD, Linda.

Chronic obstructive pulmonary disease severity influences outcomes after off-pump coronary artery bypass Benjamin Medalion, MD, Michael G. Katz, MD,

Nonelective cardiac surgery in the elderly: Is it justified?

Derrick Y. Tam, MD, Stephen E. Fremes, MD, MSc

Niv Ad, MD, Lawrence M. Wei, MD

Guidelines should bother us, not comfort us

Hisato Takagi, MD, PhD, Takuya Umemoto, MD, PhD

Influence of experience and the surgical learning curve on long-term patient outcomes in cardiac surgery Bryan M. Burt, MD, Andrew W. ElBardissi, MD,

A. Thomas Pezzella, MD, Sari D

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

Transfusion outcomes in patients undergoing coronary artery bypass grafting treated with prasugrel or clopidogrel: TRITON-TIMI 38 retrospective data analysis

A phase 2 prospective, randomized, double-blind trial comparing the effects of tranexamic acid with ecallantide on blood loss from high-risk cardiac surgery.

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

The future of cardiac surgery training: A survival guide

Commentary: “Isn't cardiac surgery a team sport?”

Reliability of risk algorithms in predicting early and late operative outcomes in high-risk patients undergoing aortic valve replacement Todd M. Dewey,

Niv Ad, MD, Sari D. Holmes, PhD, Deborah J

Apples remain apples NO matter what

National trends in utilization and in-hospital outcomes of mechanical versus bioprosthetic aortic valve replacements Abby J. Isaacs, MS, Jeffrey Shuhaiber,

Presentation transcript:

The impact of a multidisciplinary blood conservation protocol on patient outcomes and cost after cardiac surgery Niv Ad, MD, Sari D. Holmes, PhD, Jay Patel, BS, Deborah J. Shuman, BS, Paul S. Massimiano, MD, Elmer Choi, MD, David Fitzgerald, CCP, Linda Halpin, RN, MSN, Lisa M. Fornaresio, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 153, Issue 3, Pages 597-605.e1 (March 2017) DOI: 10.1016/j.jtcvs.2016.10.083 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Flow diagram of institutional blood conservation protocol. RBC, Red blood cell; Hgb, hemoglobin; HCT, hematocrit; SVO2, venous blood oxygen saturation; HCO3, bicarbonate. Reprinted with permission from Ad N, Massimiano PS, Burton NA, Halpin L, Pritchard G, Shuman DJ, Holmes SD. Effect of patient age on blood product transfusion after cardiac surgery. J Thorac Cardiovasc Surg. 2015;150:209-14. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 597-605.e1DOI: (10.1016/j.jtcvs.2016.10.083) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Kaplan–Meier 1-year survival curves comparing patients undergoing cardiac surgery in 2009 with patients in 2006 (Y axis scale truncated to 0.80-1.00; log-rank = 0.03, P = .859). CI, Confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 597-605.e1DOI: (10.1016/j.jtcvs.2016.10.083) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Incidence of blood product transfusion over time before and after implementation of the institutional blood administration protocol. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 597-605.e1DOI: (10.1016/j.jtcvs.2016.10.083) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Incidence of blood product transfusion over time by surgery group after implementation of the institutional blood administration protocol. CABG, Coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 597-605.e1DOI: (10.1016/j.jtcvs.2016.10.083) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Jitter plot demonstrating the distribution of propensity scores for 2009 (treatment units) and 2006 (control units). The Journal of Thoracic and Cardiovascular Surgery 2017 153, 597-605.e1DOI: (10.1016/j.jtcvs.2016.10.083) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Incidence of blood product transfusion before and after implementation of blood protocol. The Journal of Thoracic and Cardiovascular Surgery 2017 153, 597-605.e1DOI: (10.1016/j.jtcvs.2016.10.083) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions