Abstract:
BACKGROUND:Blood transfusion has been cited as one of the five most overutilized therapeutic procedures in the United States. We assessed the impact of clinical decision support at computerized physician order entry and education on red blood cell (RBC) transfusions and clinical patient outcomes at our institution. STUDY DESIGN AND METHODS:Clinical patient outcomes and RBC transfusions were assessed before and after implementation of a best practice alert triggered for transfusions when the hemoglobin level was higher than 7 g/dL for all inpatient discharges from January 2008 through December 2013. Retrospective clinical and laboratory data related to RBC transfusions were extracted: case-mix complexity, patient discharges and selected surgical volumes, and patient outcomes (mortality, 30-day readmissions, length of stay). RESULTS:There was a significant improvement in RBC utilization as assessed by RBC units transfused per 100 patient-days-at-risk. Concurrently, hospital-wide clinical patient outcomes showed improvement (mortality, p = 0.034; length of stay, p = 0.003) or remained stable (30-day readmission rates, p = 0.909). Outcome improvements were even more pronounced in patients who received blood transfusions, with decreased mortality rate (55.2 to 33.0, p < 0.001), length of stay (mean, 10.1 to 6.2 days, p < 0.001), and 30-day readmission rate (136.9 to 85.0, p < 0.001). The mean number of units transfused per patient also declined (3.6 to 2.7, p < 0.001). Acquisition costs of RBC units per 1000 patient discharges decreased from $283,130 in 2009 to $205,050 in 2013 with total estimated savings of $6.4 million and likely far greater impact on total transfusion-related costs. CONCLUSION:Improved blood utilization is associated with improved clinical patient outcomes.
journal_name
Transfusionjournal_title
Transfusionauthors
Goodnough LT,Maggio P,Hadhazy E,Shieh L,Hernandez-Boussard T,Khari P,Shah Ndoi
10.1111/trf.12723subject
Has Abstractpub_date
2014-10-01 00:00:00pages
2753-9issue
10 Pt 2eissn
0041-1132issn
1537-2995journal_volume
54pub_type
杂志文章相关文献
TRANSFUSION文献大全abstract::A simple method for preparing relatively pure C3c fragment from serum-reacted zymosan is described. Although hyperimmunization studies indicate contamination of the "C3c" product by C3d and immunoglobulin antigenic materials, these are present in such small amounts that they do not impair the effectiveness of the prod...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.1980.20380214904.x
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND:To investigate how a delay between pretransfusion platelet count measurement and actual platelet transfusion affects the assessment of platelet transfusion responses, the rate of reduction in platelet counts was determined in 30 patients with relatively uncomplicated thrombocytopenia. STUDY DESIGN AND METHO...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.1997.37111298088046.x
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:An influx of African migrants and refugees can strain a host country's blood services, because often migrants have unique blood needs that cannot be sourced from local donors. To increase blood donation by the new migrants, host country blood services need to understand how blood and blood donations are view...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/j.1537-2995.2010.03053.x
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Novel gel centrifugation test (GCT) cards were evaluated with respect to their ability to estimate the quantity of IgG on RBCs and the determination of the IgG subclasses IgG1 and IgG3. STUDY DESIGN AND METHODS:In 65 patients with a positive DAT, the amount of IgG-gamma-, IgG1, and IgG3 on RBCs was examined...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.2002.00076.x
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Drug-dependent antibodies have been associated with approximately 10% of acquired immune hemolytic anemia cases. These antibodies are a rare cause of interference in pretransfusion red blood cell (RBC) serologic testing. The aim of this work was to report three cases of subjects developing antibodies against...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/j.1537-2995.2011.03327.x
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Accurate typing of a patient's RBCs in the setting of prior transfusion or a hemolytic transfusion reaction is crucial in the selection of compatible blood but is time consuming, technically difficult, and sometimes impossible. To address this problem, a simple, rapid, and inexpensive quantitative PCR method...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/j.1537-2995.2004.03303.x
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Human infections with simian foamy viruses (SFVs) have been reported after occupational and nonoccupational exposure to infected animals and their tissues, blood, and body fluids, although there is no evidence for human-to-human transmission. We previously demonstrated SFV transmission in monkeys by blood tr...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/j.1537-2995.2009.02372.x
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Red blood cell (RBC) alloantibodies to nonself antigens may develop after transfusion or pregnancy, leading to morbidity and mortality in the form of hemolytic transfusion reactions or hemolytic disease of the newborn. A better understanding of the mechanisms of RBC alloantibody induction, or strategies to m...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/trf.12217
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Delayed hemolysis mediated by long-term production of pre-existing recipient-derived antibodies directed against donor RBC antigens after allogenic BMT is an unusual complication of hematopoietic transplantation. CASE REPORT:A 26-year-old man with aplastic anemia had pre-existing alloantibodies to E and c. ...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.2003.00303.x
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:In this study the applicability of a 16S rRNA real-time reverse transcriptase polymerase chain reaction (RT-PCR) and a Staphylococcus genus-specific PCR for screening of bacterial contamination in platelet concentrates (PCs) was determined. STUDY DESIGN AND METHODS:A total of 336 sample bags, from PCs that ...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/j.1537-2995.2011.03090.x
更新日期:2011-09-01 00:00:00
abstract::Iron stores were observed in 57 healthy elderly volunteers, between 63 and 77 years of age, who donated 5 units of blood over approximately 1 year. An equal number of nondonors who contributed approximately 7 mL of blood at each visit for iron status measurements only were seen at the same frequency as the donor popul...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.1991.31892023491.x
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:Prevalence estimates of the serious hazards of transfusion vary widely. We hypothesized that the current reporting infrastructure in the United States fails to capture many transfusion reactions and undertook a multicenter study using active surveillance, data review, and adjudication to test this hypothesis...
journal_title:Transfusion
pub_type: 杂志文章,多中心研究
doi:10.1111/trf.13730
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Allogeneic blood cell transplantation is a new alternative to bone marrow transplantation. Preliminary data suggest that granulocyte-colony-stimulating factor (G-CSF)-mobilized peripheral blood progenitor cells from normal donors can provide rapid hematopoietic engraftment without significant increases in tr...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.1996.36111297091734.x
更新日期:1996-11-01 00:00:00
abstract::A number of different methods exist that use chromium-51 to determine platelet survival and recovery. A 1986 article in TRANSFUSION described the recommended methods for conducting such studies in the hope of standardizing methodology and permitting interlaboratory comparison of results. The results obtained with the ...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.1990.30590296371.x
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate the effects of red blood cell (RBC) transfusion on the hemorrheologic properties and microcirculatory hemodynamics in anemic hematology outpatients receiving 2 to 4 RBC units of either "fresh" (leukoreduced storage for less than 1 week) or "aged" (leukoreduced storage...
journal_title:Transfusion
pub_type: 临床试验,杂志文章
doi:10.1111/j.1537-2995.2012.03905.x
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Partial Rh antigens have been widely described in black individuals. Carriers are prone to immunization when exposed to the normal antigens. In sickle cell disease (SCD), patient alloimmunization is a major cause of transfusion failure. The potential of individuals with partial C antigen to make anti-C has n...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/j.1537-2995.2009.02382.x
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Blood has been imbued with powerful connotations through history and across cultures. Currently bestowed with scientific meaning, blood nevertheless carries symbolic resonance. This study examines these representations among practitioners and sheds light on the clinical and nonclinical factors that guide blo...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/trf.13352
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Antibodies specific for the neutrophil antigen HNA-3a cause severe, sometimes fatal transfusion-related acute lung disease (TRALI) when transfused, but it has not been possible to screen blood donors for anti-HNA-3a because using neutrophils as targets was impractical and molecular properties of the antigen ...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/j.1537-2995.2011.03145.x
更新日期:2011-10-01 00:00:00
abstract::Because there may be inadequate dextrose in the newly licensed CPD-adenine for five or six weeks storage of high hematocrit red blood cells, this laboratory has examined some alternate sugars for their ability to maintain red blood cell metabolism during storage. In the current study, dextrose and fructose were studie...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.1980.20180125025.x
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:The addition of an appropriate metal chelator, such as diethylenetriaminopentaacetic acid (DTPA) to stored blood has been shown to be effective in a short-term (0-12 days) prevention of lipid peroxidation of stored RBCS: However, its long-term effectiveness has not been carefully evaluated. STUDY DESIGN AND...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.2001.41040556.x
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Marrow stromal cells (MSCs) for clinical trials are inevitably stored before administration, but little is known about the effects of storage on MSCs. The effects of short-term liquid storage on the in vitro function of MSCs intended for a clinical trial were studied. STUDY DESIGN AND METHODS:Early-passage ...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/j.1537-2995.2009.02138.x
更新日期:2009-07-01 00:00:00
abstract::Before the advent of electronic means of communication, postal stamps were one of the main international promotion tools on the planet and still remains an important support for the wide diffusion of a message. Since 1942, the promotion of blood donation has been one of them. To highlight these recurring or specific c...
journal_title:Transfusion
pub_type: 杂志文章,评审
doi:10.1111/j.1537-2995.2010.02671.x
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:The intrinsic properties of polypeptide blood group antigens that determine their relative immunogenicities are unknown. Because size, composition, charge, dose, and epitope glycosylation affect the immunogenicity of other polypeptides, we examined whether similar properties were related to the immunogenicit...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/trf.14609
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Research with primary human white blood cell (WBC) subpopulations requires high quantity, quality, and functionality of peripheral blood mononuclear cells (PBMCs) as a source to further characterize cellular subpopulations such as T and B lymphocytes, monocytes, or natural killer cells. Apart from buffy coat...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/trf.14616
更新日期:2018-06-01 00:00:00
abstract::The c100 hepatitis C virus (HCV) enzyme-linked immunosorbent assay (ELISA) has been used to screen blood donors to prevent transfusion-associated non-A,non-B hepatitis. This test is not specific, and only about 25 percent of c100 HCV ELISA-positive blood samples appear to transmit hepatitis C. However, the intensity o...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.1992.32492263442.x
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:RBCs modified with cyanuric chloride activated methoxy-PEG (CmPEG; 5000 Da) are less immunogenic than untreated RBCs, and their use thus may reduce the risk of alloimmunization in chronically transfused patients. STUDY DESIGN AND METHODS:To further examine the potential utility of CmPEG-RBCs, the effects of...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.2001.41101225.x
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:The prevalence of hepatitis G virus (HGV) and its strain variant, the GB agent (GBV-C) is high in non-virus-inactivated plasma products, but, persistent infection in recipients is relatively low. STUDY DESIGN AND METHODS:Stored samples from transfusion donors and recipients in a prospective study of posttra...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.1998.38398222874.x
更新日期:1998-03-01 00:00:00
abstract::It has previously been shown that buffy coat platelet concentrates (BC-PCs) stored in a medium made up of approximately 70 percent platelet storage medium (Plasma-Lyte A, PL) and 30 percent plasma (BC-PC-P) are effective in vivo after 9 to 12 days of storage. In addition to sodium, potassium, magnesium, and chloride, ...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1046/j.1537-2995.1992.32292180145.x
更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:Zika virus (ZIKV) has spread in the Americas, including parts of the southern United States, and infection can be associated with serious complications, including congenital brain abnormalities. Probable transfusion transmission of ZIKV has been documented in Brazil. STUDY DESIGN AND METHODS:Preemptive test...
journal_title:Transfusion
pub_type: 杂志文章
doi:10.1111/trf.14029
更新日期:2017-03-01 00:00:00
abstract::The studies reported in this monograph were performed between 1972 and 2002 when it was possible to study healthy male and female baboons. A colony of baboons was maintained for 30 years without any adverse events observed in these baboons in the numerous studies that were performed. These protocols were reviewed and ...
journal_title:Transfusion
pub_type: 杂志文章,评审
doi:10.1111/j.1537-2995.2006.00922.x
更新日期:2006-08-01 00:00:00