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Quality Improvement in Transfusion Practice of Orthotopic Liver Transplantation Reduces Blood Utilization, Length of Hospital Stay, and Cost
ABSTRACT Objectives Orthotopic liver transplantation (OLT) can require substantial usage of blood products. Higher rates of transfusion have been associated with increased length of hospital stay, higher rates of infection, graft failure, and mortality. This study was a retrospective analysis to ass...
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Published in: | American journal of clinical pathology 2019-03, Vol.151 (4), p.395-402 |
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container_title | American journal of clinical pathology |
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creator | Nedelcu, Elena Wright, Martha Frances Karp, Seth Cook, Makenzie Barbu, Otilia Eichbaum, Quentin |
description | ABSTRACT
Objectives
Orthotopic liver transplantation (OLT) can require substantial usage of blood products. Higher rates of transfusion have been associated with increased length of hospital stay, higher rates of infection, graft failure, and mortality. This study was a retrospective analysis to assess the impact of quality improvement interventions in OLT.
Methods
Data collection included demographics, preoperative and intraoperative data, blood utilization, and cost data. Statistical analysis was performed using R software.
Results
Total blood product utilization was reduced by approximately 50%. Statistically significant decreases were noted in blood product usage in the intraoperative and first 48-hour postoperative utilization, the number of OLTs using fewer than five RBC units, length of hospital stay, and cost.
Conclusions
This study showed successful implementation of quality improvement team interventions to reduce blood utilization during OLT. Reduced transfusion significantly correlated with decreased length of hospital stay and cost. |
doi_str_mv | 10.1093/ajcp/aqy154 |
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Objectives
Orthotopic liver transplantation (OLT) can require substantial usage of blood products. Higher rates of transfusion have been associated with increased length of hospital stay, higher rates of infection, graft failure, and mortality. This study was a retrospective analysis to assess the impact of quality improvement interventions in OLT.
Methods
Data collection included demographics, preoperative and intraoperative data, blood utilization, and cost data. Statistical analysis was performed using R software.
Results
Total blood product utilization was reduced by approximately 50%. Statistically significant decreases were noted in blood product usage in the intraoperative and first 48-hour postoperative utilization, the number of OLTs using fewer than five RBC units, length of hospital stay, and cost.
Conclusions
This study showed successful implementation of quality improvement team interventions to reduce blood utilization during OLT. Reduced transfusion significantly correlated with decreased length of hospital stay and cost.</description><identifier>ISSN: 0002-9173</identifier><identifier>EISSN: 1943-7722</identifier><identifier>DOI: 10.1093/ajcp/aqy154</identifier><identifier>PMID: 30535323</identifier><language>eng</language><publisher>UK: Oxford University Press</publisher><subject>Blood ; Blood products ; Blood Transfusion - economics ; Costs and Cost Analysis ; Data collection ; Demography ; Female ; Graft rejection ; Grafts ; Health risk assessment ; Hospitalization ; Humans ; Length of Stay - economics ; Liver transplantation ; Liver Transplantation - economics ; Liver transplants ; Male ; Middle Aged ; Original ; Quality control ; Quality Improvement ; Retrospective Studies ; Statistical analysis</subject><ispartof>American journal of clinical pathology, 2019-03, Vol.151 (4), p.395-402</ispartof><rights>American Society for Clinical Pathology, 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><rights>American Society for Clinical Pathology, 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>American Society for Clinical Pathology, 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-8e72ef41afebc6d769e07955e7f135b3ea08a0546860b966bc824c3c0955dabc3</citedby><cites>FETCH-LOGICAL-c440t-8e72ef41afebc6d769e07955e7f135b3ea08a0546860b966bc824c3c0955dabc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30535323$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nedelcu, Elena</creatorcontrib><creatorcontrib>Wright, Martha Frances</creatorcontrib><creatorcontrib>Karp, Seth</creatorcontrib><creatorcontrib>Cook, Makenzie</creatorcontrib><creatorcontrib>Barbu, Otilia</creatorcontrib><creatorcontrib>Eichbaum, Quentin</creatorcontrib><title>Quality Improvement in Transfusion Practice of Orthotopic Liver Transplantation Reduces Blood Utilization, Length of Hospital Stay, and Cost</title><title>American journal of clinical pathology</title><addtitle>Am J Clin Pathol</addtitle><description>ABSTRACT
Objectives
Orthotopic liver transplantation (OLT) can require substantial usage of blood products. Higher rates of transfusion have been associated with increased length of hospital stay, higher rates of infection, graft failure, and mortality. This study was a retrospective analysis to assess the impact of quality improvement interventions in OLT.
Methods
Data collection included demographics, preoperative and intraoperative data, blood utilization, and cost data. Statistical analysis was performed using R software.
Results
Total blood product utilization was reduced by approximately 50%. Statistically significant decreases were noted in blood product usage in the intraoperative and first 48-hour postoperative utilization, the number of OLTs using fewer than five RBC units, length of hospital stay, and cost.
Conclusions
This study showed successful implementation of quality improvement team interventions to reduce blood utilization during OLT. Reduced transfusion significantly correlated with decreased length of hospital stay and cost.</description><subject>Blood</subject><subject>Blood products</subject><subject>Blood Transfusion - economics</subject><subject>Costs and Cost Analysis</subject><subject>Data collection</subject><subject>Demography</subject><subject>Female</subject><subject>Graft rejection</subject><subject>Grafts</subject><subject>Health risk assessment</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Length of Stay - economics</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - economics</subject><subject>Liver transplants</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Quality control</subject><subject>Quality Improvement</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><issn>0002-9173</issn><issn>1943-7722</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp90ctu1DAUBmALUdGhsGKPLCEhpDbUl9hJNpVgVNpKI5VLu7Yc56TjUWKntjPS8Aw8NBlSKmDByovz6dc5_hF6Rcl7Sip-qjdmONX3OyryJ2hBq5xnRcHYU7QghLCsogU_RM9j3BBCWUnyZ-iQE8EFZ3yBfnwZdWfTDl_1Q_Bb6MElbB2-CdrFdozWO_w5aJOsAexbfB3S2ic_WINXdgthhkOnXdJpj79CMxqI-GPnfYNvk-3s91-TE7wCd5fW-5RLHwebdIe_Jb07wdo1eOljeoEOWt1FePnwHqHbT-c3y8tsdX1xtfywykyek5SVUDBoc6pbqI1sClkBKSohoGgpFzUHTUpNRC5LSepKytqULDfckMk0ujb8CJ3NucNY99CY6eagOzUE2-uwU15b9ffE2bW681slRcUpK6aAdw8Bwd-PEJPqbTTQTd8AfoyKUSGoKEUhJ_rmH7rxY3DTeYpxyauSC8kmdTwrE3yMAdrHZShR-5bVvmU1tzzp13_u_2h_1zqBtzPw4_DfpJ-5IbRh</recordid><startdate>20190301</startdate><enddate>20190301</enddate><creator>Nedelcu, Elena</creator><creator>Wright, Martha Frances</creator><creator>Karp, Seth</creator><creator>Cook, Makenzie</creator><creator>Barbu, Otilia</creator><creator>Eichbaum, Quentin</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190301</creationdate><title>Quality Improvement in Transfusion Practice of Orthotopic Liver Transplantation Reduces Blood Utilization, Length of Hospital Stay, and Cost</title><author>Nedelcu, Elena ; Wright, Martha Frances ; Karp, Seth ; Cook, Makenzie ; Barbu, Otilia ; Eichbaum, Quentin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-8e72ef41afebc6d769e07955e7f135b3ea08a0546860b966bc824c3c0955dabc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Blood</topic><topic>Blood products</topic><topic>Blood Transfusion - economics</topic><topic>Costs and Cost Analysis</topic><topic>Data collection</topic><topic>Demography</topic><topic>Female</topic><topic>Graft rejection</topic><topic>Grafts</topic><topic>Health risk assessment</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Length of Stay - economics</topic><topic>Liver transplantation</topic><topic>Liver Transplantation - economics</topic><topic>Liver transplants</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Quality control</topic><topic>Quality Improvement</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nedelcu, Elena</creatorcontrib><creatorcontrib>Wright, Martha Frances</creatorcontrib><creatorcontrib>Karp, Seth</creatorcontrib><creatorcontrib>Cook, Makenzie</creatorcontrib><creatorcontrib>Barbu, Otilia</creatorcontrib><creatorcontrib>Eichbaum, Quentin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of clinical pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nedelcu, Elena</au><au>Wright, Martha Frances</au><au>Karp, Seth</au><au>Cook, Makenzie</au><au>Barbu, Otilia</au><au>Eichbaum, Quentin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quality Improvement in Transfusion Practice of Orthotopic Liver Transplantation Reduces Blood Utilization, Length of Hospital Stay, and Cost</atitle><jtitle>American journal of clinical pathology</jtitle><addtitle>Am J Clin Pathol</addtitle><date>2019-03-01</date><risdate>2019</risdate><volume>151</volume><issue>4</issue><spage>395</spage><epage>402</epage><pages>395-402</pages><issn>0002-9173</issn><eissn>1943-7722</eissn><abstract>ABSTRACT
Objectives
Orthotopic liver transplantation (OLT) can require substantial usage of blood products. Higher rates of transfusion have been associated with increased length of hospital stay, higher rates of infection, graft failure, and mortality. This study was a retrospective analysis to assess the impact of quality improvement interventions in OLT.
Methods
Data collection included demographics, preoperative and intraoperative data, blood utilization, and cost data. Statistical analysis was performed using R software.
Results
Total blood product utilization was reduced by approximately 50%. Statistically significant decreases were noted in blood product usage in the intraoperative and first 48-hour postoperative utilization, the number of OLTs using fewer than five RBC units, length of hospital stay, and cost.
Conclusions
This study showed successful implementation of quality improvement team interventions to reduce blood utilization during OLT. Reduced transfusion significantly correlated with decreased length of hospital stay and cost.</abstract><cop>UK</cop><pub>Oxford University Press</pub><pmid>30535323</pmid><doi>10.1093/ajcp/aqy154</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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source | Oxford Journals Online |
subjects | Blood Blood products Blood Transfusion - economics Costs and Cost Analysis Data collection Demography Female Graft rejection Grafts Health risk assessment Hospitalization Humans Length of Stay - economics Liver transplantation Liver Transplantation - economics Liver transplants Male Middle Aged Original Quality control Quality Improvement Retrospective Studies Statistical analysis |
title | Quality Improvement in Transfusion Practice of Orthotopic Liver Transplantation Reduces Blood Utilization, Length of Hospital Stay, and Cost |
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