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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
Main Authors: Nedelcu, Elena, Wright, Martha Frances, Karp, Seth, Cook, Makenzie, Barbu, Otilia, Eichbaum, Quentin
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cited_by cdi_FETCH-LOGICAL-c440t-8e72ef41afebc6d769e07955e7f135b3ea08a0546860b966bc824c3c0955dabc3
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container_issue 4
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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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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. 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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. 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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. 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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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