Low Risk of HBV Breakthrough Infection in Immunosuppressive Children with HBcAb-Positive Blood Transfusion: Retrospective and Prospective Studies

2019 ◽  
Author(s):  
Yuting Yang ◽  
Jianwen Xiao ◽  
Xiuyu Zhang ◽  
Hui Yang ◽  
Zhenzhen Zhang ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Prospective Studies ◽  
Low Risk ◽  
Breakthrough Infection

Non-invasive assessment of low risk acute chest pain in the emergency department: A comparative meta-analysis of prospective studies

2015 ◽  
Vol 187 ◽  
pp. 565-580 ◽  
Author(s):  
Jorge Romero ◽  
S. Arman Husain ◽  
Anthony A. Holmes ◽  
Iosif Kelesidis ◽  
Patricia Chavez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Acute Chest Pain ◽  
Low Risk ◽  
Non Invasive

scholarly journals Triaging patients with upper gastrointestinal bleeding: the utility of Glasgow-Blatchford score

2019 ◽  
Vol 8 (1) ◽  
pp. 42
Author(s):  
Namita Mohanty ◽  
Arjun Nataraj Kannan
Keyword(s):  
High Risk ◽  
Blood Transfusion ◽  
Gastrointestinal Bleeding ◽  
Hospital Stay ◽  
Upper Gastrointestinal Bleeding ◽  
Positive Likelihood Ratio ◽  
Low Risk ◽  
P Value ◽  
Duration Of Hospital Stay ◽  
Upper Gastrointestinal

Background: Glasgow-Blatchford bleeding score (GBS), was developed to predict the need for hospital-based intervention (transfusion, endoscopic therapy or surgery) or death following upper gastrointestinal bleeding. Study evaluated the Glasgow Blatchford score’s (GBS) ability to identify high risk patients who needed blood transfusion in patients with UGI haemorrhage.Methods: A total of 270 cases admitted with upper gastrointestinal bleeding in the Medical ICU/Wards of MKCG Medical College were put on Blatchford scoring system and classified as those requiring (high risk = GBS >1) and not requiring blood transfusion (low risk) based on the score assigned on admission and a correlation between initial scoring and requirement of blood transfusion was done.Results: Units of blood transfusion required, the GBS and duration of hospital stay were significantly lower among the low risk group, all with p value <0.001. No blood transfusion was required in patients with GBS <3. There was significant correlation between GB score and requirement of blood transfusion (p <0.001) and duration of hospital stay (p <0.001). GBS had 100% sensitivity, negative predictive value and positive likelihood ratio, when a cut off of > 16 was used in predicting mortality.Conclusions: Patients presenting with Upper GI bleeding can be triaged in casualty with Glasgow Blatchford scoring. Patients with a low score of less than or equal to 3 can be safely discharged and reviewed on follow up thereby reducing admission, allowing more efficient use of hospital resources.

Hemorrhage Risk Assessment on Admission: Utility for Prediction of Maternal Morbidity

2020 ◽  
Author(s):  
Homa K. Ahmadzia ◽  
Jaclyn M. Phillips ◽  
Rose Kleiman ◽  
Alexis C. Gimovsky ◽  
Susan Bathgate ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Blood Transfusion ◽  
Maternal Morbidity ◽  
Assessment Tool ◽  
Low Risk ◽  
Risk Assessment Tool ◽  
Maternal Outcomes ◽  
Hemorrhage Risk ◽  
Low Risk Women

Objective Hemorrhage is a major cause of maternal morbidity and mortality prompting creation of innovative risk assessment tools to identify patients at highest risk. We aimed to investigate the association of hemorrhage risk assessment with maternal morbidity and to evaluate maternal outcomes after implementation of the risk assessment across hospital sites. Study Design We conducted a retrospective cohort analysis of a multicenter database including women admitted to labor and delivery from January 2015 to June 2018. The Association of Women's Health, Obstetric and Neonatal Nurses risk assessment tool was used to categorize patients as low, medium, or high risk for hemorrhage. Multivariate logistic regression was used to describe the association between hemorrhage risk score and markers of maternal morbidity and evaluate maternal outcomes before and after standardized implementations of the risk assessment tool. Results In this study, 14,861 women were categorized as low risk (26%), 26,080 (46%) moderate risk, and 15,730 (28%) high risk (N = 56,671 births). For women with high-risk scores, the relative risk (RR) ratio compared with low-risk women was 4.9 (RR: 95% confidence interval [CI]: 3.2–7.4) for blood transfusion and 5.2 (RR: 95% CI: 4.6–5.9) for estimated blood loss (EBL) ≥ 1,000 mL. For the second objective, 110,633 women were available for pre- and postimplementation analyses (39,027 and 71,606, respectively). A 20% reduction in rates of blood transfusion (0.5–0.4%, p = 0.02) and EBL ≥ 1,000 mL (6.3–5.9%, p = 0.014) was observed between pre- and postimplementations of the admission hemorrhage risk assessment tool. Conclusion Women who were deemed high risk for hemorrhage using a hemorrhage risk assessment tool had five times higher risk for blood transfusion and EBL ≥ 1,000 mL compared with low-risk women. Given the low incidence of the outcomes explored, the hemorrhage risk assessment works moderately well to identify patients at risk for peripartum morbidity. Key Points

scholarly journals A novel predictive approach for GVHD after allogeneic SCT based on clinical variables and cytokine gene polymorphisms

2018 ◽  
Vol 2 (14) ◽  
pp. 1719-1737 ◽  
Author(s):  
Carolina Martínez-Laperche ◽  
Elena Buces ◽  
M. Carmen Aguilera-Morillo ◽  
Antoni Picornell ◽  
Milagros González-Rivera ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Prospective Studies ◽  
Gene Polymorphisms ◽  
Risk Model ◽  
Low Risk ◽  
Cytokine Gene ◽  
Clinical Variables ◽  
Key Points ◽  
Predictive Approach ◽  
Cytokine Gene Polymorphisms

Key Points A risk model using donor and recipient cytokine gene polymorphisms and clinical variables significantly improves GVHD risk stratification. The model is useful in identifying patients with low-risk of developing severe GVHD, but results must be confirmed in prospective studies.

Group & save sampling in lumbar decompression: A review into current practice

2020 ◽  
Vol 31 (1-2) ◽  
pp. 15-17
Author(s):  
M McKenna ◽  
A Abdelaal
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Low Risk ◽  
Postoperative Blood Loss ◽  
Decompression Surgery ◽  
Transfusion Rate ◽  
Single Group ◽  
Multi Centre Study ◽  
Lumbar Decompression ◽  
Postoperative Blood Transfusion

The risks, benefits and technical aspects of surgery require careful consideration. One element of this is the requirement of postoperative blood transfusion. Patients who undergo elective lumbar decompression are at a low risk of requiring a postoperative transfusion yet undergo multiple preoperative group & save tests. For those who are at a low risk of bleeding, a single group & save sample may be adequate. This review analysed the postoperative blood loss and transfusion rate associated with lumbar decompression surgery without fusion in one institution. A subsequent cost analysis and review of the literature was performed. The aim was to assess whether single group & save sampling, within the context of lumbar decompression, was cost effective and amenable to the patient without impacting patient care. Average blood loss was estimated as a drop in Hb of 12.3g/dl. Six patients (14%) had Hb loss of over 20g/dl. No patients underwent a blood transfusion. Through examination of medical records, we found that 65% of patients (35) were suitable for single group & save sampling, estimating a saving of £2415.95 (53%). Selective group & save testing holds economic potential and safeguards patients from undergoing unnecessary testing. The next step after this review would be a prospective multi-centre study.

Aprotinin Use in Cardiac Surgery Patients at Low Risk for Requiring Blood Transfusion

2007 ◽  
Vol 27 (7) ◽  
pp. 988-994 ◽  
Author(s):  
Judith L Kristeller ◽  
Russell F Stahl ◽  
Brian P Roslund ◽  
Marie Roke-Thomas
Keyword(s):  
Cardiac Surgery ◽  
Blood Transfusion ◽  
Low Risk

Tranexamic acid use in high-risk blood transfusion patients undergoing total hip replacement: a randomised controlled trial

2019 ◽  
pp. 112070001988994
Author(s):  
Osamu S Kimura ◽  
Emílio HCA Freitas ◽  
Maria EL Duarte ◽  
Amanda S Cavalcanti ◽  
Marco BC Fernandes
Keyword(s):  
High Risk ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Risk Group ◽  
Low Risk ◽  
Total Hip ◽  
High Risk Patients ◽  
Risk Patients ◽  
Randomised Controlled

Introduction: We hypothesised that a single preoperative intravenous dose of tranexamic acid (TXA) is effective in patients who undergo total hip arthroplasty (THA) and are at high risk of blood transfusion (preoperative haemoglobin level <13.0 g/dL). Methods: A prospective, randomised controlled study of 308 patients who underwent primary THA was conducted. 256 participants remained in the study and were divided into 2 major groups: high-risk group comprising 116 patients with preoperative Hb < 13.0 g/dL (57 of whom were treated with a 15 mg/kg intravenous bolus of TXA, and 59 of whom did not receive the medication) and low-risk group comprising 140 patients with Hb ⩾ 13.0 g/dL (71 of whom received the same dose of TXA, and 69 of whom did not). Participants were followed up at 3 weeks, 3 months, 6 months, and 1 year after surgery. Results: The use of TXA in both groups of patients significantly increased the levels of postoperative Hb and Ht. TXA protected high-risk patients from blood loss and from transfusion. In low-risk patients the use of TXA reduced blood loss but did not protect from blood transfusion. The median length of stay was significantly affected for high-risk patients. No thromboembolic event was recorded in either group. Conclusions: TXA reduces intra- and postoperative bleeding, transfusion rates, and the length of hospital stays in patients with low preoperative Hb. The use of TXA in patients with normal preoperative Hb reduces blood loss but does not affect the transfusion rate. ClinicalTrials.gov Identifier: NCT03019198

Exploring the Validity and Operational Impact of Using Allied Health Assistants to Conduct Dysphagia Screening for Low-Risk Patients Within the Acute Hospital Setting

2020 ◽  
Vol 29 (4) ◽  
pp. 1944-1955 ◽  
Author(s):  
Maria Schwarz ◽  
Elizabeth C. Ward ◽  
Petrea Cornwell ◽  
Anne Coccetti ◽  
Pamela D'Netto ◽  
...  
Keyword(s):  
At Risk ◽  
Allied Health ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Low Risk ◽  
False Negatives ◽  
Exact Agreement ◽  
Risk Patients ◽  
Impact Phase ◽  
Operational Impact

Purpose The purpose of this study was to examine (a) the agreement between allied health assistants (AHAs) and speech-language pathologists (SLPs) when completing dysphagia screening for low-risk referrals and at-risk patients under a delegation model and (b) the operational impact of this delegation model. Method All AHAs worked in the adult acute inpatient settings across three hospitals and completed training and competency evaluation prior to conducting independent screening. Screening (pass/fail) was based on results from pre-screening exclusionary questions in combination with a water swallow test and the Eating Assessment Tool. To examine the agreement of AHAs' decision making with SLPs, AHAs ( n = 7) and SLPs ( n = 8) conducted an independent, simultaneous dysphagia screening on 51 adult inpatients classified as low-risk/at-risk referrals. To examine operational impact, AHAs independently completed screening on 48 low-risk/at-risk patients, with subsequent clinical swallow evaluation conducted by an SLP with patients who failed screening. Results Exact agreement between AHAs and SLPs on overall pass/fail screening criteria for the first 51 patients was 100%. Exact agreement for the two tools was 100% for the Eating Assessment Tool and 96% for the water swallow test. In the operational impact phase ( n = 48), 58% of patients failed AHA screening, with only 10% false positives on subjective SLP assessment and nil identified false negatives. Conclusion AHAs demonstrated the ability to reliably conduct dysphagia screening on a cohort of low-risk patients, with a low rate of false negatives. Data support high level of agreement and positive operational impact of using trained AHAs to perform dysphagia screening in low-risk patients.

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