Preoperative Anemia Is an Independent Predictor of Postoperative Mortality and Adverse Cardiac Events in Elderly Patients Undergoing Elective Vascular Operations

Gupta, Prateek K.; Sundaram, Abhishek; MacTaggart, Jason N.; Johanning, Jason M.; Gupta, Himani; Fang, Xiang; Forse, R. Armour; Balters, Marcus; Longo, G. Matthew; Sugimoto, Jeffrey T.; Lynch, Thomas G.; Pipinos, Iraklis I.

doi:10.1097/sla.0b013e318288e957

Cited by 101 publications

(63 citation statements)

References 26 publications

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“…A common challenge noted for acute events such as a fall or symptomatic infection is the frequent lack of sufficient information in clinical records on pre-existing factors that may have influenced susceptibility to a stressor that led to the event. Nevertheless, new methods such as natural language processing can capture clinical information in useful ways that will enhance the utility of clinical research to identify both exposures and outcomes (20).…”

Section: Uses Of Clinical Data In Predicting or Assessing Resiliencementioning

confidence: 99%

Report: NIA Workshop on Measures of Physiologic Resiliencies in Human Aging

Hadley

Kuchel

Newman

et al. 2017

The Journals of Gerontology: Series A

126

117

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Background/Objectives: Resilience, the ability to resist or recover from adverse effects of a stressor, is of widespread interest in social, psychologic, biologic, and medical research and particularly salient as the capacity to respond to stressors becomes diminished with aging. To date, research on human resilience responses to and factors influencing these responses has been limited. Methods: The National Institute on Aging convened a workshop in August 2015 on needs for research to improve measures to predict and assess resilience in human aging. Effects of aging-related factors in impairing homeostatic responses were developed from examples illustrating multiple determinants of clinical resilience outcomes. Research directions were identified by workshop participants. Results: Research needs identified included expanded uses of clinical data and specimens in predicting or assessing resilience, and contributions from epidemiological studies in identifying long-term predictors. Better measures, including simulation tests, are needed to assess resilience and its determinants. Mechanistic studies should include exploration of influences of biologic aging processes on human resiliencies. Important resource and infrastructure needs include consensus phenotype definitions of specific resiliencies, capacity to link epidemiological and clinical resilience data, sensor technology to capture responses to stressors, better laboratory animal models of human resiliencies, and new analytic methods to understand the effects of multiple determinants of stress responses. Conclusions: Extending the focus of care and research to improving the capacity to respond to stressors could benefit older adults in promoting a healthier life span.

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Section: Uses Of Clinical Data In Predicting or Assessing Resiliencementioning

confidence: 99%

Report: NIA Workshop on Measures of Physiologic Resiliencies in Human Aging

Hadley

Kuchel

Newman

et al. 2017

The Journals of Gerontology: Series A

126

117

View full text Add to dashboard Cite

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“…These patients had multiple comorbidities and acquired coagulopathic disorders owing to major tissue trauma, CPB, large volume fluid resuscitation and antiplatelet/anticoagulant drug therapies. In previous reports, [1,[23][24][25] major bleeding and allogenic blood transfusions have been identified as strong predictors of poor clinical outcome. In the current study, fourfold-higher perioperative mortality was found in patients requiring five PRBC or more compared with those requiring <5 units, although both groups presented similar clinical characteristics.…”

Section: Discussionmentioning

confidence: 98%

Goal-directed hemostatic therapy using the rotational thromboelastometry in patients requiring emergent cardiovascular surgery

et al. 2014

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“…Furthermore, intraoperative transfusion is associated with an increased risk of 30-day postoperative mortality for elderly patients undergoing noncardiac surgery with preoperative hematocrit levels between 30 and 35.9 % and [500 mL of intraoperative blood loss. However, transfusion is particularly harmful in patients without postoperative anemia (hemoglobin C 9.0 g/dL), with a fourfold increased risk of 30-day death [4]. In addition, patients receiving a postoperative transfusion also have significantly increased risks for 30-day mortality and morbidity, and infectious complications after noncardiac surgery [5].…”

Section: Dear Editormentioning

confidence: 99%