"TITRe"ing the approach to transfusions after cardiac surgery.

  title={"TITRe"ing the approach to transfusions after cardiac surgery.},
  author={John A. Spertus},
  journal={The New England journal of medicine},
  volume={372 11},
  • J. Spertus
  • Published 11 March 2015
  • Medicine
  • The New England journal of medicine
Cardiac surgery is a common, high-risk procedure performed on patients who are vulnerable to ischemic complications, including myocardial infarction, sepsis, stroke, and death. These patients often have myriad coexisting conditions that further raise their risk. Given the underlying clinical circumstances warranting cardiac surgery in the first place, the goal of maximizing oxygenation by maintaining adequate hemoglobin levels seems straightforward. Anemia is readily correctable by means of… 
Cardiovascular developments in 2015
The study shows the need to develop institutional protocols to manage postoperative anemia and refers to the development of artificial pacemaker fully implanted in the heart, which opens up new development possibilities for artificial cardiac pacing.
Anaemia and cardiac surgery
Although there is a predictable relationship between the severity of anaemia and mortality, even mild levels of pre-operative anaemia have an adverse effect, anaemia itself is an important cause of adverse outcomes and needs to be dealt with, notwithstanding any other associated risk factors.
Blood Transfusion and 30-Day Mortality in Patients With Coronary Artery Disease and Anemia Following Noncardiac Surgery.
Findings support a restrictive postoperative transfusion strategy in patients with stable coronary artery disease following noncardiac surgery, and interventional studies are needed to evaluate the use of a more liberal transfusion technique in patients who develop postoperative myocardial infarction.
Estimating the ratio of multivariate recurrent event rates with application to a blood transfusion study
This work uses semiparametric rate models for multivariate recurrent events to estimate blood product ratios and uses latent variables to account for multiple sources of informative censoring, and applies the method to data from the PRospective Observational Multicenter Major Trauma Transfusion study.
Perioperative red blood cell transfusion and mortality following heart transplantation: A retrospective nationwide population‐based study between 2007 and 2016 in Korea
Patients undergoing heart transplantation (HT) frequently receive perioperative red blood cell (RBC) transfusions, but the impact of perioperative transfusion on clinical outcomes after HT remains


Variation in Use of Blood Transfusion in Coronary Artery Bypass Graft Surgery
This is the first large-scale Randomized Controlled Trial of its kind to assess the impact of chemotherapy on Hematology/ Hematologic Cardiovascular/ Cardiothoracic Surgery on Surgical Physiology and Prognosis/ Outcomes.
Selecting Antiplatelet Therapy at the Time of Percutaneous Intervention for an Acute Coronary Syndrome: Weighing the Benefits and Risks of Prasugrel Versus Clopidogrel
Considering both ischemia and bleeding risk, a large proportion of TRITON participants were predicted to experience net benefit with prasugrel, a rate that increased if patients more strongly preferred avoiding ischemic events than bleeding.
Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion.
The existing evidence supports the use of restrictive transfusion triggers in most patients including those with pre-existing cardiovascular disease, and in countries with inadequate screening of donor blood, the data may constitute a stronger basis for avoiding transfusion with allogeneic red cells.
How Intermountain trimmed health care costs through robust quality improvement efforts.
It has been estimated that full implementation of the Affordable Care Act will extend coverage to thirty-two million previously uninsured Americans. However, rapidly rising health care costs could
Multivariable risk prediction can greatly enhance the statistical power of clinical trial subgroup analysis
Under many likely scenarios, a multivariable risk-stratified approach will have substantially greater statistical power than conventional subgroup analysis for detecting heterogeneity in treatment benefits and safety related to previously unidentified treatment-related harm.
Assessing and reporting heterogeneity in treatment effects in clinical trials: a proposal
This work proposes a framework that prioritizes the analysis and reporting of multivariate risk-based HTE and suggests that other subgroup analyses should be explicitly labeled either as primary sub group analyses (well-motivated by prior evidence and intended to produce clinically actionable results) or secondary (exploratory) subgroups analyses (performed to inform future research).
A Proposal
  • W. White
  • History
    The Medical and physical journal
  • 1801
Hon. Herbert P. Wilkins, Chair Hon. Peter Agnes Ferdinand Alvaro, Jr. William Apgar Navjeet Bal M. Ellen Carpenter Carol Coyne Ross Dolloff Russell Engler Hon. Dina Fein Robert B. Foster Lee
Liberal or Restrictive Transfusion after Cardiac Surgery.