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Biomedical subjects

E L Wallace

Publications and source records attributed to E L Wallace.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Changing patterns of blood transfusions in four sets of United States hospitals, 1980 to 1985.

Annual transfusion activity between 1980 and 1985 was surveyed in four sets of United States (US) hospitals, which together accounted for 4.8 percent of the red cell (RBC) transfusions in the US in 1980. Total RBC transfusion rates (total RBCs transfused/1000 hospital admissions) increased between 1980 and 1982 but remained nearly constant between 1982 and 1985. Plasma transfusion dynamics followed a similar pattern, whereas the preoperative deposit of autologous blood by patients accelerated rapidly after 1982. These changes appear to reflect responses to the acquired immune deficiency syndrome epidemic. In contrast, total platelet transfusion rates grew by 76 percent during the 6-year period, approaching total RBC rates by 1985. This is the first reported evidence in such a large sample of transfusions that total RBC transfusion rates have moderated.

Blood Transfusion↗
PubMedDate not supplied

Utility of DRG and ICD-9-CM classification codes for the study of transfusion issues. Transfusions in patients with digestive diseases.

Red cell transfusions in all patients within specific medical or surgical diagnosis-related groups (DRGs) and International Classification of Diseases (ICD-9-CM) classes were analyzed by a unique body of data that combined abstracted patient discharge records with the numbers of red cell units transfused. Informative measures of transfusion practice within an ICD-9-CM class were the proportion of patients transfused, the mean units transfused per patient, and the ratio of standard deviation to the mean of units transfused. Transfusion frequency plots (percentage of patients against units of red cells transfused per patient) revealed the existence of a modal transfusion frequency, as well as an asymmetric tail on the high frequency side. These and other features make it possible to characterize transfusion practice in specific ICD-9-CM classes. The mean units of red cells transfused for all patients in a DRG is a measure of blood resource utilization and should be useful in planning to meet future needs.

Blood Transfusion↗
PubMedDate not supplied

Red cell transfusions in total knee and total hip replacement surgery.

To explore how red cell transfusions were used to support patients who underwent primary and revision hip and knee replacements classified within diagnosis-related group (DRG) 209 (major joint and limb reattachment procedures), we studied abstracted patient discharge records from 151 United States hospitals in 1986. A total of 9684 units of whole blood and/or separated red cells was used to support 6472 patients. The transfusion use varied by surgical procedure, with patient gender as an influencing factor. Large proportions of patients underwent surgery without requiring transfusion. Among transfused patients, the majority received 1 to 3 units of red cells; however, a minority of patients required multiple transfusions, thereby utilizing a disproportionate share of the blood resource. Comparison of transfusion practice within the seven most active hospitals revealed significant differences (p less than or equal to 0.01) in the percentage of patients actually transfused, but not in the mean number of units of red cell components transfused per transfused patient. Similar findings emerged from comparison of transfusion practice when all hospitals were segregated into five hospital classes on the basis of orthopedic surgical service activity. These effects were seen for both total knee and total hip replacement procedures. It can be concluded that the lack of clearly defined criteria for transfusion contributed to the variations observed.

Blood Transfusion↗