title: Prophylactic Plasma Transfusion Before Interventional Radiology Procedures Is Not Associated With Reduced Bleeding Complications.
abstract: To determine the association between prophylactic plasma transfusion and periprocedural red blood cell (RBC) transfusion rates in patients with elevated international normalized ratio (INR) values undergoing interventional radiology procedures.
  
  
  
  In this retrospective cohort study, adult patients undergoing interventional radiology procedures with a preprocedural INR available within 30 days of the procedure during a study period of January 1, 2009, to December 31, 2013, were eligible for inclusion. Baseline characteristics, coagulation parameters, transfusion requirements, and procedural details were extracted. Univariate and multivariable propensity-matched analyses were used to assess the relationships between prophylactic plasma transfusion and the outcomes of interest, with a primary outcome assessed a priori of RBC transfusion occurring during the procedure or within the first 24 hours postprocedurally.
  
  
  
  A total of 18,204 study participants met inclusion criteria for this study, and 1803 (9.9%) had an INR of 1.5 or greater before their procedure. Of these 1803 patients, 196 patients (10.9%) received prophylactic plasma transfusion with a median time of 1.9 hours (interquartile range [IQR], 1.1-3.2 hours) between plasma transfusion initiation and procedure initiation. In multivariable propensity-matched analysis, plasma administration was associated with increased periprocedural RBC transfusions (odds ratio, 2.20; 95% CI, 1.38-3.50; P<.001) and postprocedural intensive care unit admission rates (odds ratio, 2.11; 95% CI, 1.41-3.14; P<.001) as compared with those who were not transfused preprocedurally. Similar relationships were seen at higher INR thresholds for plasma transfusion.
  
  
  
  In patients undergoing interventional radiology procedures, preprocedural plasma transfusions given in the setting of elevated INR values were associated with increased periprocedural RBC transfusions. Additional research is needed to clarify this potential association between preprocedural plasma transfusion and periprocedural RBC transfusion.
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN; Periprocedural Outcomes, Information and Transfusion Study Group, Mayo Clinic, Rochester, MN.
authors: Matthew A
authors: MA
authors: Warner
authors: Department of Vascular and Interventional Radiology, Mayo Clinic, Rochester, MN.
authors: David A
authors: DA
authors: Woodrum
authors: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors: Andrew C
authors: AC
authors: Hanson
authors: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors: Darrell R
authors: DR
authors: Schroeder
authors: Periprocedural Outcomes, Information and Transfusion Study Group, Mayo Clinic, Rochester, MN; Anesthesia Clinical Research Unit, Mayo Clinic, Rochester, MN.
authors: Gregory A
authors: GA
authors: Wilson
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN; Periprocedural Outcomes, Information and Transfusion Study Group, Mayo Clinic, Rochester, MN. Electronic address: kor.daryl@mayo.edu.
authors: Daryl J
authors: DJ
authors: Kor
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016913:Blood Component Transfusion / Q000379:methods / Q000592:standards*; D015897:Comorbidity; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D019934:International Normalized Ratio / Q000592:standards; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010949:Plasma; D057216:Propensity Score; D015641:Radiography, Interventional / Q000009:adverse effects* / Q000592:standards / Q000706:statistics & numerical data; D012189:Retrospective Studies