{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:28:44Z","timestamp":1787617724154,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T00:00:00Z","timestamp":1665964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Preoperative coagulation screening for patients without bleeding disorders remains controversial. The combinatorial risk of INR, aPTT, and platelet count (PLT) abnormalities leading to bleeding requiring transfusion is not known in these patients. We examined the association between abnormal coagulation profile and the risk of transfusion following common elective surgery in patients without bleeding disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>We utilized the National Surgical Quality Improvement Program (NSQIP) database from 2004 to 2018 to identify patients without a history of bleeding disorders undergoing common 23 major elective procedures across 10 specialties. Multivariable logistic regression was used to assess the association between coagulation profile and bleeding requiring packed red blood cell transfusion intra\u2212\/post\u2010operatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 672,075 patients meeting inclusion criteria, 53.7% presented with normal coagulation profile preoperatively. Overall, 12.2% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a082,368) received transfusion. In the setting of normal aPTT\/PLT, both\n                      <jats:italic>Equivocal<\/jats:italic>\n                      INR of 1.1\u20131.5 (aOR 1.41, 95% CI 1.38\u20131.44) and\n                      <jats:italic>Abnormal<\/jats:italic>\n                      INR of &gt;1.5 (aOR 1.81, 95% CI 1.71\u20131.93) were significantly associated with an increased risk of transfusion.\n                      <jats:italic>Equivocal<\/jats:italic>\n                      (60\u201370) and\n                      <jats:italic>Abnormal<\/jats:italic>\n                      (&gt;70) aPTT with normal INR\/PLT did not demonstrate a comparable risk of transfusion. We observed a synergistic effect of combinatorial lab abnormalities on the risk of transfusion when both\n                      <jats:italic>Abnormal<\/jats:italic>\n                      INR\/aPTT and\n                      <jats:italic>Low<\/jats:italic>\n                      PLT of &lt;100,000 were present (aOR 5.18, 95% CI 3.04\u20138.84), compared to the effect of\n                      <jats:italic>Abnormal<\/jats:italic>\n                      INR\/aPTT and normal\/elevated PLT (aOR 1.90, 95% CI 1.48\u20132.45).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The preoperative presence of abnormal findings in INR or PLT was significantly associated with the risk of bleeding requiring transfusion during intraoperative and postoperative periods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.17146","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T06:11:30Z","timestamp":1665987090000},"page":"2223-2234","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Association between isolated abnormal coagulation profile on transfusion following major surgery: A\n                    <scp>NSQIP<\/scp>\n                    analysis of individuals without bleeding disorders"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8841-8676","authenticated-orcid":false,"given":"Kelvin","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Urology Houston Methodist Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Satkunasivam","sequence":"additional","affiliation":[{"name":"Department of Urology Houston Methodist Hospital  Houston Texas 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