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In hospitalized patients undergoing therapeutic plasma exchange, major bleeding prevalence depends on the bleeding definition: An analysis of The Recipient Epidemiology and Donor Evaluation Study-III.
Soares Ferreira Junior, Alexandre; Lessa, Morgana Pinheiro Maux; Sanborn, Kate; Kuchibhatla, Maragatha; Karafin, Matthew S; Onwuemene, Oluwatoyosi A.
Afiliação
  • Soares Ferreira Junior A; Department of Medicine, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil.
  • Lessa MPM; Department of Medicine, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil.
  • Sanborn K; Duke Biostatistics, Epidemiology and Research Design Core, Duke University School of Medicine, Durham, North Carolina, USA.
  • Kuchibhatla M; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA.
  • Karafin MS; Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Onwuemene OA; Division of Hematology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
J Clin Apher ; 38(6): 694-702, 2023 Dec.
Article em En | MEDLINE | ID: mdl-37548357
BACKGROUND: Major bleeding in patients undergoing therapeutic plasma exchange (TPE) has been studied in large databases; but without standardizing bleeding definitions. Therefore, we used standardized definitions to evaluate major bleeding in hospitalized patients undergoing TPE using public use data files from the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III). STUDY DESIGN AND METHODS: In a retrospective cross-sectional analysis, we identified TPE-treated adults in a first inpatient encounter. We evaluated major bleeding prevalence using (1) International Classification of Diseases (ICD) or Current Procedural Terminology (CPT) codes, (2) packed red blood cell (PRBC) transfusion, or (3) hemoglobin (Hgb) decline. Patients with major bleeding prior to their first TPE were excluded from the analysis. RESULTS: Among 779 patients undergoing TPE, major bleeding by at least one of the three bleeding definitions occurred in 135 patients (17.3%). For each of the ICD/CPT, PRBC, and Hgb definitions, the prevalence of major bleeding was 2.8% (n = 31), 7.4% (n = 81), and 5.4% (n = 59), respectively. Only 3.7% of bleeds (5/135) were captured by all three definitions and 19.3% (26/135) exclusively by any two pairwise definitions. The addition of PRBC transfusion and Hgb decline to ICD/CPT code definitions increased bleeding prevalence threefold. CONCLUSION: Among hospitalized adults undergoing TPE in the REDS-III study, the prevalence of major bleeding was 17.3%. The addition of PRBC and Hgb decline to ICD codes increased bleeding prevalence threefold. Future studies are needed to develop validated models that identify patients at risk for major bleeding during TPE.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Troca Plasmática / Hemorragia Tipo de estudo: Prevalence_studies / Risk_factors_studies / Screening_studies Limite: Adult / Humans Idioma: En Revista: J Clin Apher Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Troca Plasmática / Hemorragia Tipo de estudo: Prevalence_studies / Risk_factors_studies / Screening_studies Limite: Adult / Humans Idioma: En Revista: J Clin Apher Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos