OBJECTIVES: To gather data on current preoperative transfusion practice and postoperative complications in sickle cell disease (SCD) as a prelude to a randomised trial. METHODS: A prospective one year survey of 114 SCD patients undergoing elective surgery in 31 English hospitals was undertaken. RESULTS: 43%, 39% and 23% of patients respectively [corrected] received no transfusion, top-up and exchange transfusion preoperatively. Overall postoperative complication rates were 18%, 26% and 17%, with SCD related complications of 12%, 8% and 0% respectively. 85% of patients with [corrected]HbSC/HbSss(+)thalassaemia and 71% of obstetric and gynaecology patients were not transfused preoperatively, whereas 59% patients undergoing ENT procedures and 83% of hip replacements had top-up and exchange transfusions respectively. Multivariable logistic regression analysis revealed that having moderate/high risk procedures was a predictor of postoperative complications (OR 4.9 (95% CL: 1.3 to 18), P = 0.017) [corrected] while preoperative transfusion was not (OR 1.7, (95% CL: [corrected] 0.5 to 6), P = 0.41). CONCLUSION: The lack of clear benefit of transfusion confirms the need for a randomised controlled trial of transfusion vs. no transfusion in patients with HbSS and HbSss(0)thalassaemia. (c) Blackwell Munksgaard 2005.
OBJECTIVES: To gather data on current preoperative transfusion practice and postoperative complications in sickle cell disease (SCD) as a prelude to a randomised trial. METHODS: A prospective one year survey of 114 SCDpatients undergoing elective surgery in 31 English hospitals was undertaken. RESULTS: 43%, 39% and 23% of patients respectively [corrected] received no transfusion, top-up and exchange transfusion preoperatively. Overall postoperative complication rates were 18%, 26% and 17%, with SCD related complications of 12%, 8% and 0% respectively. 85% of patients with [corrected]HbSC/HbSss(+)thalassaemia and 71% of obstetric and gynaecology patients were not transfused preoperatively, whereas 59% patients undergoing ENT procedures and 83% of hip replacements had top-up and exchange transfusions respectively. Multivariable logistic regression analysis revealed that having moderate/high risk procedures was a predictor of postoperative complications (OR 4.9 (95% CL: 1.3 to 18), P = 0.017) [corrected] while preoperative transfusion was not (OR 1.7, (95% CL: [corrected] 0.5 to 6), P = 0.41). CONCLUSION: The lack of clear benefit of transfusion confirms the need for a randomised controlled trial of transfusion vs. no transfusion in patients with HbSS and HbSss(0)thalassaemia. (c) Blackwell Munksgaard 2005.
Authors: Soheir Adam; Jude Jonassaint; Hillary Kruger; Melanie Kail; Eugene P Orringer; James R Eckman; Allison Ashley-Koch; Marilyn J Telen; Laura M De Castro Journal: Am J Med Date: 2008-10 Impact factor: 4.965
Authors: Marie E Steiner; Nicole D Zantek; Simon J Stanworth; Robert I Parker; Stacey L Valentine; Leslie E Lehmann; Cassandra D Josephson; Scot T Bateman; Naomi L C Luban Journal: Pediatr Crit Care Med Date: 2018-09 Impact factor: 3.624