Publications by authors named "Suma Choorapoikayil"

Article Synopsis
  • Anemia is a serious health concern that leads to increased morbidity and mortality, and this study investigates how preoperative hemoglobin levels relate to in-hospital mortality, comparing men and women.
  • Analyzing data from over 842,000 surgical patients in Germany, the researchers found that lower preoperative hemoglobin levels significantly increased the odds of in-hospital mortality.
  • The study identified a hemoglobin threshold of 10.5 g/dL, indicating that below this level, women face a higher risk of death compared to men, emphasizing the need for tailored anemia management to ensure equitable patient care.
View Article and Find Full Text PDF

In the perioperative setting, a suboptimal total hemoglobin (Hb) mass puts women and men at an unreasonable disadvantage. Anemia is an independent risk factor for transfusion, postoperative complications, and mortality. The Hb cut-off value for women was set at <12.

View Article and Find Full Text PDF

Placenta accreta spectrum (PAS) has become a significant life-threatening issue due to its increased incidence and associated morbidity and mortality. Pregnancy is often associated with states of anaemia, and severe maternal haemorrhage represents a major risk factor for red blood cell (RBC) transfusion. The present study retrospectively analyzed the prevalence of anaemia, transfusion requirements and outcome in women with PAS.

View Article and Find Full Text PDF

Purpose Of Review: Postpartum anemia (PPA) is common in women after childbirth and affects about 50-80% of all women worldwide. Iron deficiency (ID) is the main cause for anemia and constitutes a potentially preventable condition with great impact on the mother's physical and mental condition after delivery. In most cases, PPA is associated with antenatal ID and peripartum blood losses.

View Article and Find Full Text PDF

Background: One of the leading causes of maternal death worldwide is severe obstetric haemorrhage after childbirth. Use of intraoperative cell salvage is strongly recommended by international guidelines on patient blood management. Recent data provide strong evidence that use of cell salvage in obstetrics is effective and safe in women with postpartum haemorrhage resulting in fewer transfusion-related adverse events and shorter hospital stay.

View Article and Find Full Text PDF

Background: Diagnostic laboratory tests are an integral part of managing hospitalized patients. In particular, patients in the intensive care units (ICUs) can experience a concerning amount of blood loss due to diagnostic testing, which can increase the risk developing iatrogenic anemia. Several interventions exist to curtail avoidable blood loss, for example computerized decision support, smaller phlebotomy tubes, and other blood conservation devices.

View Article and Find Full Text PDF

Background: Iron deficiency (ID) is the leading cause of anemia worldwide. The prevalence of preoperative ID ranges from 23 to 33%. Preoperative anemia is associated with worse outcomes, making it important to diagnose and treat ID before elective surgery.

View Article and Find Full Text PDF
Article Synopsis
  • The 2022 European Society of Cardiology guidelines update the previous 2014 guidelines for cardiovascular assessment and management of patients undergoing non-cardiac surgery, focusing on standardized perioperative care.
  • These guidelines stress the importance of assessing both patient risk factors and the risks associated with the surgical procedure itself.
  • A key feature is the new Patient Blood Management program, which aims to optimize hemoglobin levels, reduce unnecessary blood loss, and improve tolerance to anemia to enhance patient outcomes.
View Article and Find Full Text PDF

Background: Patient Blood Management (PBM) is a patient-centred, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient's own blood whilst promoting patient safety and empowerment. The effectiveness and safety of PBM over a longer period have not yet been investigated.

Methods: We performed a prospectively designed, multicentre follow-up study with non-inferiority design.

View Article and Find Full Text PDF

Anaemia is among the most common co-morbidity in surgical patients. However, it often remains unrecognized and untreated, which results in an increased requirement for allogeneic blood products and complications. Patient Blood Management offers patient-centred and evidence-based therapies and preventive measures for anaemia.

View Article and Find Full Text PDF

Purpose Of Review: The value of healthcare is defined as the achieved health outcome in relation to the incurred costs. Patient Blood Management (PBM) is a multidisciplinary, evidence-based and patient-centred concept to optimize the patients' red blood cell mass, minimize blood loss and bleeding and to secure the physiological reserve, including the promotion of evidence-based transfusion strategies. This review describes the healthcare value and the cost effectiveness of single PBM measures as well as the implementation of comprehensive PBM programmes.

View Article and Find Full Text PDF

Background: Blood transfusions are common medical procedures and every age group requires detailed insights and treatment bundles. The aim of this study was to examine the association of anaemia, co-morbidities, complications, in-hospital mortality, and transfusion according to age groups to identify patient groups who are particularly at risk when undergoing surgery.

Methods: Data from 21 Hospitals of the Patient Blood Management Network Registry were analysed.

View Article and Find Full Text PDF

Red blood cell (RBC) transfusion is a life-saving medical intervention and has an essential role in the management of surgical patients. However, blood donations and supply levels are decreasing, therefore there is an unmet need for the accurate prediction of the transfusion probability for surgical patients. Multiple methods have been established to predict the need for RBC transfusion.

View Article and Find Full Text PDF

Study Objective: We explored the feasibility of a Clinical Decision Support System (CDSS) to guide evidence-based perioperative anticoagulation.

Design: Prospective randomised clinical management simulation multicentre study.

Setting: Five University and 11 general hospitals in Germany.

View Article and Find Full Text PDF

Background: Age and preoperative anaemia are risk factors for poor surgical outcome and blood transfusion. The aim of this study was to examine the effect of iron supplementation in iron-deficient (ID) elderly patients undergoing major surgery.

Method: In this single-centre observational study, patients ≥ 65 years undergoing major surgery were screened for anaemia and ID.

View Article and Find Full Text PDF

Purpose: Anaemia is common in patients presenting with aneurysmal subarachnoid (aSAH) and intracerebral haemorrhage (ICH). In surgical patients, anaemia was identified as an idenpendent risk factor for postoperative mortality, prolonged hospital length of stay (LOS) and increased risk of red blood cell (RBC) transfusion. This multicentre cohort observation study describes the incidence and effects of preoperative anaemia in this critical patient collective for a 10-year period.

View Article and Find Full Text PDF

Patient Blood Management (PBM) aims to diagnose and treat preoperative anaemia, avoid unnecessary blood loss, and enable rational use of blood products. Due to various limitations, treatment of preoperative anaemia has been successful in only a few German hospitals to date. Thus, the peri- and postoperative phase is increasingly becoming important for implementing various preventive and therapeutic measures for the treatment of (postoperative) anaemia.

View Article and Find Full Text PDF

Background: Anemia remains one of the most common comorbidities in intensive care patients worldwide. The cause of anemia is often multifactorial and triggered by underlying disease, comorbidities, and iatrogenic factors, such as diagnostic phlebotomies. As anemia is associated with a worse outcome, especially in intensive care patients, unnecessary iatrogenic blood loss must be avoided.

View Article and Find Full Text PDF

Purpose Of Review: Patients admitted to ICUs are a heterogeneous group, displaying multiple anaemia risk factors and comorbidities. Clinicians should therefore take all possible measures to identify modifiable risks. Patient Blood Management (PBM) is an approach promoting the timely application of evidence-based interventions designed to maintain patients own blood mass.

View Article and Find Full Text PDF

Introduction: Patient blood management (PBM) is a clinical and multidisciplinary, 3-pillar concept. The aim of this study was to detect the subjective increase in physician's awareness towards perioperative anaemia, patient's blood resource, and transfusion after the implementation of PBM in German hospitals.

Material And Methods: A survey among 56 hospitals from the German PBM Network group was conducted from October 27 to December 19, 2020.

View Article and Find Full Text PDF