Publications by authors named "Jeffrey L Carson"
Article Synopsis
- * It involves a subgroup analysis of over 3,100 participants from the MINT clinical trial conducted across multiple countries between 2017 and 2023, with a 30-day follow-up period and primary outcomes related to death or recurrent MI.
- * Results indicated that 34.3% of participants had acute anemia, and the researchers explored the link between anemia type and post-MI outcomes, assessing various secondary complications as well.
Background: The optimal hemoglobin threshold to guide red blood cell (RBC) transfusion for patients with acute myocardial infarction (MI) and anemia is uncertain.
Objective: To estimate the efficacy of 4 individual hemoglobin thresholds (<10 g/dL [<100 g/L], <9 g/dL [<90 g/L], <8 g/dL [<80 g/L], and <7 g/dL [<70 g/L]) to guide transfusion in patients with acute MI and anemia.
Design: Prespecified secondary analysis of the MINT (Myocardial Ischemia and Transfusion) trial using target trial emulation methods.
Loss of taste and smell is one of the most troubling symptoms of long COVID and may be permanent for some. Correlation between subjectively and objectively assessed olfactory and gustatory impairment is low, leading to uncertainty about how many people are affected, how many recover, and to what extent. We prospectively investigated the effects of COVID-19 on long-term chemosensory function in a university and hospital-based cohort in NJ.
View Article and Find Full Text PDFBackground: Current risk stratification tools for acute myocardial infarction (AMI) have limitations, particularly in predicting mortality. This study utilizes cardiac ultrasound radiomics (i.e.
View Article and Find Full Text PDFBackground: The MINT trial (Myocardial Ischemia and Transfusion) raised concern for harm from a restrictive versus liberal transfusion strategy in patients with acute myocardial infarction (MI) and anemia. Type 1 and type 2 MI are distinct pathophysiologic entities that may respond differently to blood transfusion. This analysis sought to determine whether the effects of transfusion varied among patients with a type 1 or a type 2 MI and anemia.
View Article and Find Full Text PDFBackground: Although anemia is common in patients with myocardial infarction (MI), management remains controversial. We quantified the association of anemia with in-hospital outcomes and resource utilization in patients admitted with MI using a large national database.
Methods: All hospitalizations with a primary diagnosis code for acute MI in the National Inpatient Sample (NIS) between 2014 and 2018 were identified.
Article Synopsis
- A study compared two blood transfusion strategies for patients with myocardial infarction and low hemoglobin: a restrictive strategy (transfusion if hemoglobin <7 or 8 g/dL) and a liberal strategy (transfusion if hemoglobin <10 g/dL).
- Involving 3,504 patients, results showed that the liberal group received significantly more transfusions but did not experience a reduced risk of death or recurrent myocardial infarction at 30 days compared to the restrictive group.
- The findings suggest that while the liberal strategy may not improve outcomes, the potential risks of the restrictive strategy remain uncertain, indicating the need for further research.
Background: The effects of spinal versus general anesthesia on long-term outcomes have not been well studied. This study tested the hypothesis that spinal anesthesia is associated with better long-term survival and functional recovery than general anesthesia.
Methods: A prespecified analysis was conducted of long-term outcomes of a completed randomized superiority trial that compared spinal anesthesia versus general anesthesia for hip fracture repair.
Article Synopsis
- Red blood cell transfusions can be beneficial but come with potential risks, necessitating guidelines for their use in both adults and children.
- Studies involved numerous randomized controlled trials which found that restrictive transfusion strategies (transfusing at lower hemoglobin thresholds) generally do not harm patient outcomes for most populations.
- Recommendations include using restrictive strategies for stable adult patients, advising transfusions at hemoglobin levels below 7 g/dL, with some exceptions based on specific patient conditions like cardiac or orthopedic surgeries.
Red blood cell (RBC) transfusion is a common clinical intervention used to treat patients with acute and chronic anemia. The decision to transfuse RBCs in the acute setting is based on several factors but current clinical studies informing optimal RBC transfusion decision making (TDM) are largely based upon hemoglobin (Hb) level. In contrast to transfusion in acute settings, chronic RBC transfusion therapy has several different purposes and is associated with distinct transfusion risks such as iron overload and RBC alloimmunization.
View Article and Find Full Text PDFBackground: Meta-analyses of randomized controlled trials (RCTs) evaluating thresholds for red blood cell (RBC) transfusion typically focus on mortality; however, other outcomes are highly relevant. The aim of this study is to summarize the effects of different transfusion thresholds on the outcomes of quality of life (QoL) and function.
Study Design: We extracted data from RCTs identified in a recently published Cochrane systematic review.
Context: Hip fracture is a serious injury that can lead to increased morbidity and mortality. Vitamin D binding protein (DBP) is a potential prognostic indicator of outcomes since it is important for actin scavenging and inflammation after tissue injury.
Objective: To determine whether circulating DBP is associated with mobility or mortality after hip fracture and its association with acute tissue injury markers.
Background: The clinical outcomes of SARS-CoV-2 infection vary in severity, potentially influenced by the resident human microbiota. There is limited consensus on conserved microbiome changes in response to SARS-CoV-2 infection, with many studies focusing on severely ill individuals. This study aimed to assess the variation in the upper respiratory tract microbiome using saliva specimens in a cohort of individuals with primarily mild to moderate disease.
View Article and Find Full Text PDFIntroduction: The effect of spinal versus general anesthesia on the risk of postoperative delirium or other outcomes for patients with or without cognitive impairment (including dementia) is unknown.
Methods: Post hoc secondary analysis of a multicenter pragmatic trial comparing spinal versus general anesthesia for adults aged 50 years or older undergoing hip fracture surgery.
Results: Among patients randomized to spinal versus general anesthesia, new or worsened delirium occurred in 100/295 (33.
Background: Accumulating evidence from clinical trials suggests that a lower (restrictive) hemoglobin threshold (<8 g/dL) for red blood cell (RBC) transfusion, compared with a higher (liberal) threshold (≥10 g/dL) is safe. However, in anemic patients with acute myocardial infarction (MI), maintaining a higher hemoglobin level may increase oxygen delivery to vulnerable myocardium resulting in improved clinical outcomes. Conversely, RBC transfusion may result in increased blood viscosity, vascular inflammation, and reduction in available nitric oxide resulting in worse clinical outcomes.
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