SHM Converge Scientific Abstract ePoster Gallery-Pre-Procedure Transfusion and Bleeding Complication Experience of a Medicine Procedure Service

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This retrospective cohort study examined hospitalized patients undergoing bedside paracentesis at the University of Michigan from July 2021 to July 2023, comparing procedures performed by a Medicine Procedure Service (MPS) versus non-MPS providers. The study aimed to assess whether MPS’s “no strict cutoff” approach to pre-procedure platelet and INR thresholds, aligned with AASLD guidance, affected blood product use and bleeding outcomes.<br /><br />A total of 177 paracenteses were analyzed: 84 by non-MPS providers and 93 by MPS. Patient characteristics were broadly similar between groups, including age, sex, comorbidity burden, hemoglobin, platelet count, and INR.<br /><br />The main finding was that MPS-performed paracentesis was associated with significantly fewer pre-procedure blood transfusions than non-MPS procedures (7.5% vs 17.9%, p=0.04). However, there was no significant difference in post-procedure bleeding events within 24 hours (0% vs 3.6%, p=0.10) or in post-procedure blood transfusion (0% vs 3.6%, p=0.10).<br /><br />Overall, the study suggests that a more restrictive transfusion strategy before paracentesis can reduce blood product use without increasing bleeding risk. The authors note that further research is needed, especially in patients with cirrhosis and those with very low platelet counts, where evidence remains limited.

Asset Subtitle

Gabriella Rubick

Meta Tag

Author List Alexander Harris, Anna Conlon, Blake Haller, Brett Curtis, David Paje, Gabriella Rubick, Jacklyn N. Thibert, Jonathan T. Sebolt, Katie Liu, Maxwell Krasity, Michael Adams, Sachita Shrestha, Shuo Tian, Stephanie Taylor, Trevor Denton

Category Research

Concept Paracentesis

Concept Blood Product Transfusion

Concept Post-procedure Bleeding

Concept Retrospective Cohort Study

Concept MPS Provider

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author Gabriella Rubick

Track Value in Hospital Medicine

Keywords

paracentesis

retrospective cohort

medicine procedure service

blood transfusion

platelet threshold

INR

bleeding risk

hospitalized patients

AASLD guidance

cirrhosis

Paracentesis

Blood Product Transfusion

Post-procedure Bleeding

Retrospective Cohort Study

MPS Provider