کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2979288 1578592 2015 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Should asymptomatic patients discharged with lower hemoglobin expect worse outcomes after valve surgery?
ترجمه فارسی عنوان
آیا بیماران بدون علامت که با هموگلوبین پایین تر تخلیه می شوند، نتایج بدتر از عمل جراحی شیر را انتظار می کشند؟
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی

ObjectiveBlood transfusion in cardiac surgery patients is associated with increased morbidity and cost. The decision to transfuse patients after surgery varies but is often based on low hemoglobin (Hgb) levels, regardless of symptom status. This study examined whether asymptomatic patients discharged with lower Hgb levels had increased risk for perioperative complications and 1-year mortality.MethodsBetween 2008 and mid-2014, a total of 1107 valve-only procedures were performed. Patients discharged alive with complete data (N = 1044) were divided into 2 groups with discharge Hgb levels of ≤8 g/dL (n = 153) or >8 g/dL (n = 891). Propensity score matching was conducted between Hgb groups, resulting in 152 patient pairs.ResultsIn multivariate analyses, discharge Hgb level did not predict 30-day mortality (odds ratio [OR] = 1.01, P = .991), 1-year survival (hazard ratio [HR] = 0.87, P = .34), or readmission <30 days (OR = 0.92, P = .31). Furthermore, after propensity score matching, no differences were found between groups with Hgb levels ≤8 versus >8 g/dL in 30-day mortality (0% vs 0.7%, P > .99) or readmissions (14% vs 16%, P = .52). Cumulative 1-year survival was similar between matched groups with discharge Hgb level of ≤8 versus >8 g/dL (89.3% vs 91.4%, P = .67). Matched groups with Hgb level ≤8 versus >8 g/dL had similar physical (28% vs 18% increase; P = .27) and mental (7% vs 6% increase; P = .94) health-related quality of life (HRQL) improvements at 6 months.ConclusionsAsymptomatic patients discharged with lower Hgb levels did not manifest inferior outcomes, including perioperative morbidity/mortality, readmission <30 days, HRQL, and 1-year survival. The practice of blood transfusion to correct lower Hgb levels in asymptomatic patients should be eliminated, as it may be associated with increased morbidity without apparent clinical benefits after valve surgery.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Thoracic and Cardiovascular Surgery - Volume 150, Issue 5, November 2015, Pages 1322–1329
نویسندگان
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