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Blood Management

Blood Utilization in Medicare Cardiac Surgery Patients
DRG DESCRIPTION % USE
104 Cardiac valve & other major cardiothoracic procedures with cardiac catheterization 60.4%
105 Cardiac valve & other major cardiothoracic procedures without cardiac catheterization 74.0%
106 Coronary bypass with PTCA 89.9%
107 Coronary bypass with cardiac catheterization 81.6%
108 Other cardiothoracic procedures 78.6%
109 Coronary bypass without PTCA or cardiac catheterization 75.6%
 
Medicare Provider Analysis and Review File data for 1999 for all 5000 hospitals collecting Medicare funds

*Mahoney CB. Cardiac surgery: patient numbers and revenue: Heart Surg Forum. 2003;6(4):202

Patients undergoing thoracic surgical procedures, particularly cardiovascular procedures, often require considerable transfusions of allogeneic blood.  These transfusions can lead to complications including:

  • adult respiratory distress syndrome
  • infections
  • atrial fibrillation
  • kidney and liver function complications

These can lead to greater ICU and hospitals stays having a negative impact on overall patient outcomes.  According to a recent study**, 30% of the variance in transfusion rates could be attributable to hospital site with significant increases in infections, mortality, and 30 day readmission.

Better Blood Management

Sacramento Cardiovascular utilizes a multi-modality approach that incorporates medical, pharmacological, and technological techniques to reduce the necessity for allogeneic transfusions.  This approach is endorsed by the Society of Thoracic Surgeons and has lead to measurable differences to other practices.

Center of Excellence
The Sacramento Cardiovascular Surgeons and Sutter Memorial Hospital have been recognized nationally by Medtronic as a select Center of Excellence for it’s Rethinking Blood Conservation Initiative.  This program is focused on an evidence-based approach to better patient care with regard to transfusions and incorporates a multi-disciplinary team including Surgeons, Anesthesia, Perfusion, Nursing, and more.  As an advanced leader in this area, the Sacramento Cardiovascular Surgeons and Sutter Memorial team lead the way to minimize the use of blood products for their own patients while training other centers around the country on best practices to improve patient outcomes on a broad basis.