The usefulness of a classification and regression tree algorithm for detecting perioperative transfusion‐related pulmonary complications

Kim, Kyu Nam; Kim, Dong Won; Jeong, Mi Ae

doi:10.1111/trf.13202

Cited by 17 publications

(13 citation statements)

References 31 publications

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“…), although the TACO+F appeared to have fewer severe disturbances than the latter (29 vs. 42%, P = 0·23). TACO‐F cases also experienced a trend towards longer length of stay (LOS) 22 days [IQR 11–40] vs. 12 ; P = 0·08.…”

Section: Resultsmentioning

confidence: 99%

“…The basis of TACO recognition has been hydrostatic, while inflammatory features traditionally argue against (and certainly not for) it. Indeed, more recent protocols for automated alerts do not solicit fever or other manifestations of inflammation . Whether fever copresenting with dyspnoea may distract reviewers from deducing TACO is also not known.…”

Section: Introductionmentioning

confidence: 99%

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The association of fever with transfusion‐associated circulatory overload

et al. 2016

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Transfusion-associated circulatory overload disproportionately exhibits fever compared with allergic reactions. However, TACO+F did not associate with patient or product age, nor reflect severity. To better understand TACO+F, the fever-congestion sequence merits attention. Further study is needed to see whether TACO+F occurs as reproducibly elsewhere, and in association with atherosclerosis in a better characterized cohort.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The association of fever with transfusion‐associated circulatory overload

et al. 2016

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“…Recent advances in high-throughput bioinformatic techniques enable the identification of inflammatory marker cut-off points in a data-driven approach obviating the use of artificial cut-offs [9] . Classification and regression tree (CART) analysis represents one such approach [10] .…”

Section: Introductionmentioning

confidence: 99%

Do Inflammatory Indices Play a Role in Distinguishing between Uncomplicated and Complicated Diverticulitis?

et al. 2016

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Background: The usefulness of inflammatory indices in assessment of the severity of acute diverticulitis remains unestablished. The aim of this study was to determine whether inflammatory indices and hematological ratios could be utilised to differentiate between uncomplicated and complicated diverticulitis. Methods: Hematological and inflammatory indices were recorded for each admission with CT confirmed acute diverticulitis (101 complicated, 127 uncomplicated). Cases were divided into training (n = 57) and test sets (n = 171). A classification and regression tree (CART) analysis was employed in the training set to identify optimal inflammatory marker cut-off points associated with complicated diverticulitis. Samples (test set) were then categorized as (A) greater than and (B) less than CART identified cut-off points. The predictive properties of inflammatory marker cut-off points in distinguishing severity of diverticulitis were assessed using a univariate logistic regression analysis, summary receiver operating characteristic curves and confusion matrix generation. Results: C-reactive protein >109 mg/ml (OR 3.07, 95% CI 1.43-6.61, p = 0.004, area under the curve; AUC = 0.64) and white cell lymphocyte ratio (WLR) >17.72 (OR 4.23, 95% CI 1.95-9.17, p < 0.001, AUC = 0.64) were the most accurate parameters in distinguishing complicated and uncomplicated disease. WCC >21 × 10⁹/l (p = 0.02, AUC = 0.60) and lymphocyte count >0.55 × 10⁹/l (p = 0.009, AUC = 0.60) were less accurate. Conclusion: Widely used inflammatory indices are useful in the depiction of complicated diverticulitis. The indices cut-off points highlighted in this study should be considered at the time of diagnosis in combination with radiological features of complicated diverticulitis.

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“…It has been clearly proved that allogeneic FFP and PC transfusions carry high risks of bacterial contamination, allergic reactions, febrile reactions, venous thromboembolism, multiple organ failure, transfusion-related acute lung injury, transfusion-related circulatory overload [10], and poor wound healing [11] The strict avoidance of inappropriate FFP and PC transfusions might improve both the outcomes and prognoses of these patients as well as reduce transfusion-associated hospital costs [11]. Otherwise, the risk-benefit ratio of a FFP and PC transfusion strategy on the basis of abnormal laboratory test results in the absence of active bleeding is poorly understood [6,12].…”

Section: Discussionmentioning

confidence: 99%

Rotational Thromboelastometry Helps to Reduce Blood Product Consumption in Critically Ill Patients during Small Surgical Procedures at the Intensive Care Unit - a Retrospective Clinical Analysis and Literature Search

Vymazal

Astraverkhava

Durila

2018

Transfus Med Hemother

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Background: Patients at intensive care units (ICUs) are often transfused to correct increased coagulation parameters (prothrombin time and activated partial thromboplastine time) and/or low platelet count. Thromboelastometry using whole blood is considered to be superior to these tests. In clinical praxis, prolonged standard tests are seen but thromboelastometry values are normal. The objective was to compare the blood product consumptions before and after the introduction of thromboelastometry assays into the treatment protocol during small surgical procedures at our mixed ICU. Methods: We analyzed 1,879 patients treated at our ICU who underwent small interventions. We compared the fresh frozen plasma and platelet consumption before and after the introduction of rotational thromboelastometry into the routine use. The obtained data were compared to relevant research results from the PubMed database, the MeSH index in the Medline database, and Google Scholar using key words ‘tromboelastometry', ‘fresh frozen plasma' and ‘platelets'. Results: Annual fresh frozen plasma and platelet consumptions were significantly decreased following thromboelastometry introduction. The number of patients and procedures did not differ significantly during the periods analyzed. Conclusion: Routine thromboelastometry assays can enable significant reduction of blood product consumption in critically ill patients undergoing small surgery without any bleeding complications.

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The usefulness of a classification and regression tree algorithm for detecting perioperative transfusion‐related pulmonary complications

Abstract: Low specificity of the CART algorithm adopted previously indicated its limited diagnostic value in the Republic of Korea. A new algorithm is needed to facilitate the detection of transfusion-related complications.

Cited by 17 publications

References 31 publications

The association of fever with transfusion‐associated circulatory overload

The association of fever with transfusion‐associated circulatory overload

Do Inflammatory Indices Play a Role in Distinguishing between Uncomplicated and Complicated Diverticulitis?

Rotational Thromboelastometry Helps to Reduce Blood Product Consumption in Critically Ill Patients during Small Surgical Procedures at the Intensive Care Unit - a Retrospective Clinical Analysis and Literature Search

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