Blood transfusion in children with sickle cell disease undergoing tonsillectomy

Atwood, Carlyn M.; Gnagi, Sharon H.; Teufel, Ronald J.; Nguyen, Shaun A.; White, David R.

doi:10.1016/j.ijporl.2017.10.013

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…The use of preoperative transfusion is a source of significant controversy. Case‐by‐case decision‐making is the standard of care in the majority of reports . Prospective clinical studies on this question are presented in Table (all primary research in Table S2).…”

Section: Resultsmentioning

confidence: 99%

Perioperative care of children with sickle cell disease: A systematic review and clinical recommendations

et al. 2019

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Children with sickle cell disease (SCD) require specific perioperative care, and clinical practice in this area remains poorly defined. We aimed to conduct a systematic, PRISMA-based review of the literature, available clinical guidelines and practice recommendations. We also aimed to extract any valuable information for the "best of available-evidence"-based prevention of perioperative adverse events in children with SCD, and highlight the most urgent priorities in clinical research. As data sources, USWe also included institutional, consortia and expert group guidelines. Included were reports/guidelines in English, French, German, and Italian. Excluded were reports on obstetrical and fetal management. We identified 202 reports/guidelines fulfilling the criteria outlined above. A majority focused on visceral, cardiovascular and orthopedic surgery procedures, and only five were multicenter randomized controlled trials and two prospective randomized studies. After grading of the quality of the evidence, the extracted data was summarized into clinical recommendations for daily practice. Additionally, we designed a risk-grading algorithm to identify contexts likely to be associated with adverse outcomes. In conclusion, we provide a systematic PRISMA-based review of the existing literature and ancillary practice and delineate a set of clinical recommendations and priorities for research.

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Section: Resultsmentioning

confidence: 99%

Perioperative care of children with sickle cell disease: A systematic review and clinical recommendations

et al. 2019

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“…Although the need for preoperative transfusion in high and medium-risk procedures is compelling, to date, the literature supporting transfusion in lowrisk procedures is conflicting. 3,22,23 TAPS did not have a sufficient number of low-risk surgeries to comment on the impact of preoperative transfusions in this sub-set of patients. However, most cases of ACS developed in patients undergoing mediumrisk surgeries.…”

Section: Discussionmentioning

confidence: 95%

“…However, we were unable to assess compliance with the protocol as part of this study. Although the need for preoperative transfusion in high and medium-risk procedures is compelling, to date, the literature supporting transfusion in low-risk procedures is conflicting 3,22,23 . TAPS did not have a sufficient number of low-risk surgeries to comment on the impact of preoperative transfusions in this sub-set of patients.…”

Section: Discussionmentioning

confidence: 99%

Reassessing the Need for Preoperative Transfusions in Sickle Cell Disease Patients With an Elevated Baseline Hemoglobin—A Retrospective Study

Yan

Tole

Bair

et al. 2022

Journal of Pediatric Hematology/Oncology

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Background: Current guidelines recommend a preoperative hemoglobin of 10.0 g/dL in patients with sickle cell disease [SCD], however, this threshold continues to be an area of controversy. Previous studies demonstrating the benefits of preoperative transfusions have largely not captured patients with elevated baseline hemoglobin, in part due to low hydroxyurea uptake and exclusion of nonhemoglobin SS SCD. Materials and Methods: We conducted a retrospective chart review of patients with SCD <18 years of age undergoing low and medium-risk procedures at 2 academic medical centers in Canada between 2007 and 2017. The primary objective was to study the association of preoperative transfusion on postoperative complications in patients with SCD with baseline hemoglobin between 9.0 and 10.0 g/dL. Multivariable logistic regression was used to estimate the adjusted effect of preoperative transfusion on the risk of developing postoperative complications. Results: In all, 159 procedures in patients with hemoglobin <9.0 g/dL [Hb<9.0] and 173 procedures in patients with hemoglobin between 9.0 and 10.0 g/dL [Hb9.0-10.0] were analyzed. In the absence of preoperative transfusion, Hb9.0-10.0 patients had lower overall complications [23% vs. 34%] compared with Hb<9.0 patients [OR 0.29, 95% CI 0.12-0.72, P=0.008]. In total, 75% of Hb<9.0 and 21% of Hb9.0-10.0 patients received a preoperative simple transfusion. Transfusion was associated with increased risk of postoperative complications in Hb9.0-10.0 [OR 3.02, 95% CI 1.26-7.23, P=0.013], but not Hb<9.0 patients [OR 0.64, 95% CI 0.28-1.45, P=0.30]. Conclusions: Simple transfusion may not be warranted in Hb9.0-10.0 patients undergoing low-risk procedures. Prospective studies validating these findings are needed.

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“…There was an equal split in the pattern for reported units of analysis, with per patient (47%) [22-24, 29, 31, 32, 35, 42, 43, 47-49, 54-56, 58-61] and per hospital admission (50%) [25-28, 30, 33, 34, 36-42, 44, 46, 50, 51, 53, 57] as the most frequently reported units. Inpatient costs [22,23,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] were the most frequently reported cost component, followed by outpatient [23, 24, 31, 32, 35, 39, 42-44, 47, 48, 51, 54, 56, 58-61], pharmacy [22-24, 31, 32, 35, 42, 43, 47, 48, 56, 58-61], and ED costs [22,23,29,31,35,…”

Section: Study Demographicsmentioning

confidence: 99%

Medical and Non-medical Costs of Sickle Cell Disease and Treatments from a US Perspective: A Systematic Review and Landscape Analysis

Baldwin

Jiao

Basu

et al. 2022

PharmacoEconomics Open

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Background Sickle cell disease (SCD) is a complex genetic disorder that manifests in infancy and progresses throughout life in the form of acute and chronic complications. As the upfront costs of potentially curative, genetic therapies will likely be high, an assessment and comprehensive characterization of the medical and non-medical cost burden will inform future decision making. Objective We sought to systematically summarize the existing literature surrounding SCD medical and non-medical costs. Methods We searched MEDLINE and EMBASE (2008-2020) and identified US-based studies that detailed medical or non-medical costs. Eligible studies provided empirical estimates about any aspect of cost or SCD individuals of all ages and their caregivers. Study quality was assessed using the Newcastle-Ottawa Scale, and costs were adjusted to 2019 US$. Results Search queries returned 479 studies, with 342 from medical burden searches and 137 from non-medical burden searches, respectively. Herein, we report the results of the 40 studies that contained relevant cost information: 39 detailed medical costs and 1 detailed non-medical costs. Costs were higher for SCD patients when compared with non-SCD individuals

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Blood transfusion in children with sickle cell disease undergoing tonsillectomy

Cited by 8 publications

References 15 publications

Perioperative care of children with sickle cell disease: A systematic review and clinical recommendations

Perioperative care of children with sickle cell disease: A systematic review and clinical recommendations

Reassessing the Need for Preoperative Transfusions in Sickle Cell Disease Patients With an Elevated Baseline Hemoglobin—A Retrospective Study

Medical and Non-medical Costs of Sickle Cell Disease and Treatments from a US Perspective: A Systematic Review and Landscape Analysis

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