Morbidity but not mortality is decreased after off-pump coronary artery bypass surgery.

Background: Off-pump coronary bypass surgery (CABG) has been advocated to avoid the physiologic perturbations related to cardiopulmonary bypass and improve outcomes compared with on-pump CABG. Previous reports have been inconsistent, and thus its benefits remain uncertain. This retrospective study compared outcomes between on-pump and off-pump CABG from a large multicenter cohort of propensity-matched patients.

Transfusion of 1 and 2 units of red blood cells is associated with increased morbidity and mortality.

Background: This study examined the relationship between transfusion of 1 or 2 units of red blood cells (RBCs) and the risk of morbidity and mortality after isolated on-pump coronary artery bypass grafting (CABG).

Methods: A total of 22,785 consecutive patients underwent isolated on-pump CABG between January 1, 2008, and December 31, 2011 in Michigan. We excluded 5,950 patients who received three or more RBC units.

Transfusion rate as a quality metric: is blood conservation a learnable skill?

Background: Between January 2008 and December 2012, a multicenter quality collaborative initiated a focus on blood conservation as a quality metric, with educational presentations and quarterly reporting of institutional-level perioperative transfusion rates and outcomes. This prospective cohort study was undertaken to determine the effect of that initiative on transfusion rates after isolated coronary artery bypass grafting (CABG).

Methods: Between January 1, 2008, and December 31, 2012, 30,271 patients underwent isolated CABG in Michigan.

Is resternotomy a risk for continuous-flow left ventricular assist device outcomes?

Background: The number of patients undergoing resternotomy continues to rise. Although catastrophic hemorrhage remains a dreaded complication, most published data suggest that sternal reentrance is safe, with negligible postoperative morbidity and mortality. A significant proportion of left ventricular assist device (LVAD) implantations are reoperative cardiac procedures.

Significance of postoperative acute renal failure after continuous-flow left ventricular assist device implantation.

Background: Deteriorating renal function is common in patients with advanced heart failure and is associated with poor outcomes. The relationship between renal function and left ventricular assist device (LVAD) implantation is complex and has been explored in multiple studies with contradictory results. The aim of our study is to examine the significance of postoperative renal failure after implantation of a continuous-flow LVAD and its relationship to outcomes.

Skin-of-color epidemiology: a report of the most common skin conditions by race.

To quantify and compare diagnoses according to race in pediatric Health Maintenance Organization (HMO) health plan patients seen in a general dermatology clinic over a 10-year period. Retrospective cohort of health plan pediatric patients seen in the dermatology clinic between 1997 and 2007 was established using an electronic medical record database. Diagnoses and diagnostic codes were recorded according to International Classification of Diseases, Ninth Revision (ICD-9) diagnostic codes grouped on their first three digits.

Preoperative predicted risk does not fully explain the association between red blood cell transfusion and mortality in coronary artery bypass grafting.

Objective: Perioperative red blood cell transfusion is associated with increased morbidity and mortality after coronary artery bypass grafting (CABG). Whether transfusion is a cause of these outcomes or serves as a surrogate for a high-risk patient population remains uncertain. This retrospective study tested the hypothesis that increased preoperative risk profile of patients receiving transfusion would explain the relationship between red blood cell transfusion and operative mortality in isolated CABG.

Distal pancreatectomy with or without splenectomy: comparison of postoperative outcomes and surrogates of splenic function.

Objectives: Published data on splenic preservation during distal pancreatectomy have been inconsistent. We hypothesized that patients undergoing spleen-preserving distal pancreatectomy (SPDP) would have fewer infectious and non-infectious complications than those undergoing en bloc distal pancreatectomy with splenectomy (DPS), and that their haematological parameters would be consistent with splenic function.

Methods: Of 97 patients who underwent either SPDP using the Warshaw technique or en bloc DPS, 78 met our study inclusion criteria.