An observational study in Blood Transfusion, sponsored by Clinic for Cardiovascular Diseases Magdalena. Completed. Open to participants aged 18 Years to 90 Years. Per ClinicalTrials.gov, last updated 2019-03-29.
Sponsored by Clinic for Cardiovascular Diseases Magdalena · Observational
Open surgery on the abdominal aorta is a high risk procedure associated with an intravascular volume blood loss and thereby, with high requirement for blood and blood product transfusion.
The aim of this study was to establish the rate for allogenic blood transfusion (ABT) during elective open abdominal aortic surgery and find parameters associated with ABT requirements.
Two distinct clinical entities affect the abdominal aorta: abdominal aortic aneurysm (AAA) and aortoiliac occlusive disease (AIOD). These are multifactorial vascular disorders caused by complex genetic and environmental factors. Older patients with more comorbidity are often affected. Open abdominal aortic surgery is associated with high mortality rate. Even in specialised institutions it varies from 2 to 5%. Similar results can be compared to mortality for coronary artery bypass grafting. This reflects the complexity of the surgery and the general health of those patients. It is associated with intravascular volume blood loss and, thereby, with a high requirement for blood and blood products transfusion. Allogenic blood transfusion (ABT) has been associated with an increased risk of tumour recurrence, postoperative infection, acute lung injury, perioperative myocardial infarction, postoperative low-output cardiac failure, and increased mortality.
In the last decades, multiple strategies have been undertaken to prevent massive intraoperative blood loss during elective surgery and allogenic blood transfusion requirement. One of the method advocates a preoperative increase in red blood cells level using B12, folic acid and iron supplements or with erythropoietin usage. Other methods involve the optimisation of surgical technique and the use of a machine for intraoperative blood salvage, known as "cell saver".
The aim of this study was to establish the rate for ABT during elective open abdominal aortic surgery, find parameters associated with ABT requirements, and optimise the investigators hospital's maximum surgical blood ordering schedule (MSBOS).
This is the only study on the registry with Clinic for Cardiovascular Diseases Magdalena as lead sponsor.
Counted across the registry records on this site, refreshed daily.
A retrospective cross-sectional study was conducted using an existing computerised medical records database at the Department of Anaesthesiology and Intensive Care at the Clinic for Cardiovascular Diseases Magdalena. This Clinic is a tertiary hospital in Croatia specialised in cardiac and vascular surgery. This study is a retrospective analysis of consecutive patients undergoing elective major vascular surgery who had been prospectively risk-stratified.
Exclusion Criteria:
Group received allogenic blood transfusion (ABT) alongside with autologous blood from intraoperative cell saver (ICS) during elective open abdominal aortic surgery.
Other: Allogenic blood transfusion (ABT)
Group received only autologous blood from intraoperative cell saver (ICS) during elective open abdominal aortic surgery.
During elective open aortic surgery, the autologous blood from ICS was processed and re-transfused in all patients. However, TR group additionally received ABT.
Overall ABT requirement
Overall ABT requirement (in %) during elective abdominal aortic surgery with the use of ICS for intraoperative blood salvage and autologous transfusion.
Time frame: Retrospective analysis, 6-year period
Age as the predictor of higher ABT requirement
(years)
Time frame: Retrospective analysis, 6-year period
Gender as the predictors of higher ABT requirement
male/female
Time frame: Retrospective analysis, 6-year period
Body mass index (BMI) as the predictors of higher ABT requirement
BMI (kg/m2)
Time frame: Retrospective analysis, 6-year period
Body surface area (BSA) as the predictors of higher ABT requirement
BSA (m²)
Time frame: Retrospective analysis, 6-year period
Total blood volume as the possible predictors of higher ABT requirement
TBV (in liters) calculated trough Nadler's formula
Time frame: Retrospective analysis, 6-year period
Hemoglobin (Hb) and hematocrit (Htc) as the predictors of higher ABT requirement
Hb (g/L) and Htc (%)
Time frame: Retrospective analysis, 6-year period
Type of illness as the predictor of higher ABT requirement
abdominal aortic aneurysm or aortoiliac occlusive disease
Time frame: Retrospective analysis, 6-year period
Patient's comorbidities as the predictors of higher ABT requirement
arterial hypertension, coronary artery disease, diabetes, atrial fibrillation, cerebrovascular incidents, chronic obstructive pulmonary disease, chronic renal insufficiency, malignancy
Time frame: Retrospective analysis, 6-year period
Medications that impair coagulation and homeostasis as the predictor of higher ABT requirement
acetylsalicylic acid, clopidogrel, or warfarin
Time frame: Retrospective analysis, 6-year period
Postoperative duration of mechanical ventilation
(hours)
Time frame: Retrospective analysis, 6-year period
Length of stay (LOS)
LOS in ICU (days) and overall hospital LOS (days)
Time frame: Retrospective analysis, 6-year period
In-hospital mortality rate
(in %)
Time frame: Retrospective analysis, 6-year period
No study locations are listed for this record.
Plan to share: Undecided
This study is completed, as verified in Mar 2019. You cannot join it, but the record below documents what was studied.
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