Evidence map›Paper›PMID 34055586›Full record

ArticleWorld journal of orthopedics2021

Reducing unnecessary crossmatching for hip fracture patients by accounting for preoperative hemoglobin concentration.

Raj M Amin, Varun Puvanesarajah, Yash P Chaudhry, Matthew J Best, Sandesh S Rao, Steven M Frank, Erik A Hasenboehler

Open access · diamondAbstract read
In one paragraph

Article in World journal of orthopedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Raj M AminDepartment of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA 94305, United States.
Varun PuvanesarajahDepartment of Orthopaedic Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21205, United States.
Yash P ChaudhryDepartment of Orthopaedic Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19122, United States.
Matthew J BestDepartment of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MD 02114, United States.
Sandesh S RaoDepartment of Orthopaedic Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21205, United States.
Steven M FrankDepartment of Anesthesiology, Critical Care Medicine, Baltimore, MD 21205, United States.
Erik A HasenboehlerDepartment of Orthopaedics, Johns Hopkins School of Medicine, Baltimore, MD 21205, United States. ehasenb1@jhmi.edu.
Johns Hopkins University · USMassachusetts General Hospital · USPhiladelphia College of Osteopathic Medicine · USStanford Medicine · USUniversity of Maryland, Baltimore · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMaximum surgical blood order schedules were designed to eliminate unnecessary preoperative crossmatching prior to surgery in order to conserve blood bank resources. Most protocols recommend type and cross of 2 red blood cell (RBC) units for patients undergoing surgery for treatment of hip fracture. Preoperative hemoglobin has been identified as the strongest predictor of inpatient transfusion, but current maximum surgical blood order schedules do not consider preoperative hemoglobin values to determine the number of RBC units to prepare prior to surgery.

aimTo determine the preoperative hemoglobin level resulting in the optimal 2:1 crossmatch-to-transfusion (C:T) ratio in hip fracture surgery patients.

methodsIn 2015 a patient blood management (PBM) program was implemented at our institution mandating a single unit-per-occurrence transfusion policy and a restrictive transfusion threshold of < 7 g/dL hemoglobin in asymptomatic patients and < 8 g/dL in those with refractory symptomatic anemia or history of coronary artery disease. We identified all hip fracture patients between 2013 and 2017 and compared the preoperative hemoglobin which would predict a 2:1 C:T ratio in the pre PBM and post PBM cohorts. Prediction profiling and sensitivity analysis were performed with statistical significance set at

resultsFour hundred and ninety-eight patients who underwent hip fracture surgery between 2013 and 2017 were identified, 291 in the post PBM cohort. Transfusion requirements in the post PBM cohort were lower (51%

conclusionThe hip fracture maximum surgical blood order schedule should consider preoperative hemoglobin in determining the number of units to type and cross prior to surgery.

Indexed as

Blood conservationHemoglobinHip fractureMaximum surgical blood order scheduleTransfusionType and cross

Identifiers

PMID34055586
PMCPMC8152439
OpenAlexW3160333768

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.