{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T16:28:48Z","timestamp":1769617728315,"version":"3.49.0"},"reference-count":52,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,8,31]],"date-time":"2020-08-31T00:00:00Z","timestamp":1598832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23HL151826"],"award-info":[{"award-number":["K23HL151826"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI120938"],"award-info":[{"award-number":["R01AI120938"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI128779"],"award-info":[{"award-number":["R01AI128779"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["T32AI102623"],"award-info":[{"award-number":["T32AI102623"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>With improved safety of allogeneic blood supply, the use of preoperative autologous donations (PADs) and perioperative autologous cell salvage (PACS) has evolved. This study evaluated temporal trends in PAD and PACS use in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The National Inpatient Sample database, a stratified probability sample of 20% of hospitalizations in the United States, was used to compare temporal trends in hospitalizations reporting use of PADs and PACS from 1995 to 2015. Factors associated with their use were examined between 2012 and 2015 with use of multivariable Poisson regression. Sampling weights were applied to generate nationally representative estimates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a steady decrease in hospitalizations reporting PAD transfusions from 27.90 per 100\u2009000 in 1995 to 1.48 per 100\u2009000 hospitalizations in 2015 (<jats:italic>P<\/jats:italic>\u2010trend &lt;.001). In contrast, PACS increased from a rate of 1.16 per 100\u2009000 in 1995 to peak of 20.51 per 100\u2009000 hospitalizations in 2008 and then steadily declined (<jats:italic>P<\/jats:italic>\u2010trend&lt;.001). Higher odds of PACS and PADs were observed in older patients, elective procedures (vs urgent), and urban teaching\/nonteaching hospitals (vs rural hospitals) (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). PACS was more common in hospitalizations in patients with higher levels of severity of illness as compared to those with minor severity (adjusted prevalence ratio [adjPR], 2.39; 95% confidence interval [CI], 2.08\u20102.73; <jats:italic>P<\/jats:italic>&lt;.001), while PADs were performed less often in patients with higher underlying severity of illness (All Patient Refined Diagnosis Related Groups, 4 vs 1, adjPR, 0.61; 95% CI, [0.39\u20100.95]; <jats:italic>P<\/jats:italic> = .028).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There was a significant decrease in PAD red blood cell transfusions, while PACS has increased and subsequently decreased; PACS plays an important role in surgical blood conservation. The subsequent decline in PACS likely reflects further optimization of transfusion practice through patient blood management programs and improvement of surgical interventions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15949","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T03:36:54Z","timestamp":1598931414000},"page":"2260-2271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparative changes of <scp>pre\u2010operative<\/scp> autologous transfusions and <scp>peri\u2010operative<\/scp> cell salvage in the United States"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-9905","authenticated-orcid":false,"given":"Ruchika","family":"Goel","sequence":"first","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"},{"name":"Mississippi Valley Regional Blood Center  Davenport Iowa USA"},{"name":"Simmons Cancer Institute, Southern Illinois University School of Medicine  Springfield Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly R.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2174-5004","authenticated-orcid":false,"given":"Eshan U.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Packman","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-9517","authenticated-orcid":false,"given":"Evan M.","family":"Bloch","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5354-3899","authenticated-orcid":false,"given":"Eric A.","family":"Gehrie","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parvez M.","family":"Lokhandwala","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M.","family":"Ness","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2270-4821","authenticated-orcid":false,"given":"Beth","family":"Shaz","sequence":"additional","affiliation":[{"name":"New York Blood Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis M.","family":"Katz","sequence":"additional","affiliation":[{"name":"Mississippi Valley Regional Blood Center  Davenport Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3533-3190","authenticated-orcid":false,"given":"Steven M.","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0517-3766","authenticated-orcid":false,"given":"Aaron A. R.","family":"Tobian","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,31]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2015.04.001"},{"key":"e_1_2_7_3_1","first-page":"10","article-title":"Pre\u2010operative autologous blood donation: clinical parameters and efficacy","volume":"9","author":"Singbartl G","year":"2011","journal-title":"Blood Transfus"},{"key":"e_1_2_7_4_1","first-page":"307","article-title":"Autologous blood donation and isovolemic hemodilution\u2013indications and practical implementation","volume":"20","author":"Penner M","year":"1993","journal-title":"Infusionsther Transfusionsmed"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198802253180803"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1985.25285169225.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198401123100201"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2002.00132.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-11-833996"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181baf0ac"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2010.02622.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2009.02195.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2020.02.001"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2002.t01-2-04212.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13644"},{"key":"e_1_2_7_16_1","first-page":"CD001888","article-title":"Cell salvage for minimising perioperative allogeneic blood transfusion","volume":"4","author":"Carless PA","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002549"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12527"},{"key":"e_1_2_7_19_1","first-page":"139","article-title":"Intra\u2010operative cell salvage: a fresh look at the indications and contraindications","volume":"9","author":"Esper SA","year":"2011","journal-title":"Blood Transfus"},{"key":"e_1_2_7_20_1","unstructured":"HCUP National Inpatient Sample (NIS).Overview of the HCUP Nationwide Impatient Sample 2011. Healthcare Cost and Utilization Project (HCUP). Rockville MD: Agency for Healthcare Research and Quality; 2012.www.hcup-us.ahrq.gov\/nisoverview.jsp. Last Accessed May 15 2020."},{"key":"e_1_2_7_21_1","unstructured":"HCUP National Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP).Overview of the HCUP Nationwide Impatient Sample. Rockville MD: Agency for Healthcare Research and Quality; 2012.www.hcup-us.ahrq.gov\/nisoverview. Last Accessed May 15 2020."},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1992.32692367192.x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2017.03.010"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01108.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1995.35895357894.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540100042026"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199902183400706"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318254d1a3"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03293.x"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03111.x"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03116.x"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3148.1997.d01-43.x"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05500-x"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-019-03271-y"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2017.0287"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003303"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14331"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.9185"},{"key":"e_1_2_7_39_1","first-page":"CD002042","article-title":"Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion","volume":"10","author":"Carson JL","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_40_1","first-page":"CD002042","article-title":"Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion","volume":"4","author":"Carson JL","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12785"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002397"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001851"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12233"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000465"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000116"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001981"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh314"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2001.41040530.x"},{"key":"e_1_2_7_50_1","unstructured":"Comparative Analysis of HCUP and NHDS Inpatient Discharge Data. Agency for Healthcare Research and Quality; 1996.https:\/\/www.hcup-us.ahrq.gov\/db\/nation\/nis\/reports\/NIS_1996_Design_Report.jsp. Last Accessed July 18 2020."},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-10-605493"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.20121"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15088"}],"updated-by":[{"DOI":"10.1111\/trf.18372","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T00:00:00Z","timestamp":1754697600000}}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.15949","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.15949","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.15949","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T10:19:56Z","timestamp":1693822796000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.15949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,31]]},"references-count":52,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1111\/trf.15949"],"URL":"https:\/\/doi.org\/10.1111\/trf.15949","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,31]]},"assertion":[{"value":"2020-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}