The use of hydroxyurea and postoperative heparin prophylaxes were also included in the recorded observations made by the researchers. Standard statistical techniques including regression analysis were used to determine the levels of correlation that existed between transfusion therapy, pharmaceutical use, and complications.
Materials
As this was a retrospective study that did not involve any direct experimentation or even direct observation, the materials used were rather minimal compared to many other clinical surveys. Patient records formed the entirety of the research materials used; these were accessed in accordance with privacy laws and ethical standards for the use of private medical information, with the records rendered anonymous prior to primary research being conducted and with full hospital permission. Records were accessed primarily electronically, though hard copies of the seventy-five case histories actually used as subjects in the study were also obtained after having been sanitized of identifying information.
Materials used in analysis were equally minimal, as the statistical analysis performed in this retrospective manner required only a computer terminal and the software necessary to perform statistical analysis after information from the seventy-five included case histories had been input as data. Standard software was used for this purpose, with the bulk of the analysis conducted using the latest available version of the SPSS software mist typically used for statistical analysis in such cases. Encryption of data was utilized to some degree, though to a fairly minimal extent as there was not considered to be a high risk of unauthorized access nor of potential damage caused by the unauthorized release of any of the data used in the study, as no personally identifying information was entered into the software program alongside the individual data points that formed the primary data for this research.
Discussion of Tables
The current literature shows a great deal of disagreement as to the benefits, if any, of various forms of perioperative and preoperative procedures as a means of reducing postoperative complications in patients with sickle cell disease undergoing surgery (Al-Samak et al. 2008; Buck et al. 2005; Hirst & Williamson 2001; Vichinsky et al. 1995; Haberken et al. 1997). It was hoped that this research would help provide more conclusive results as to the efficacy of various preoperative and perioperative treatments and their effects on postoperative outcomes, despite the relatively small sample size and the use of only a single medical institution in the retrospective analysis. As might have been expected based on previous results of similar research, however, this did not prove to be the case, and the results of this research as discussed below remain fairly inconclusive in these regards.
The preoperative and perioperative treatments that were specifically examined in this study were the administering of heparin prior to surgery, the administering of hydroxyurea as a standard course of medication and/or prior to surgery, and transfusions -- whether simple transfusions or exchange transfusions -- prior to and during surgery. Measures of postoperative complications that were examined in this research included levels and rates of postoperative fever, vaso-occlusive crises, acute chest syndromes, and length of hospital stay. Information regarding basic demographic, the type of surgery performed in each case, and the preoperative appearance of vaso-occlusive crises and acute chest syndromes was also collected, but was not analyzed for correlation.
The subjects in the study had a mean age of twenty-four-and-a-half years; surgery durations had a mean of sixty-seven minutes with a standard deviation of approximately forty-eight minutes, and mean hemoglobin concentration was measured...
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