{"id":"https://openalex.org/W7141522706","doi":"https://doi.org/10.1016/j.sipas.2026.100345","title":"The changing patient profile: A retrospective study of trends in perioperative bleeding management and challenges in surgical care","display_name":"The changing patient profile: A retrospective study of trends in perioperative bleeding management and challenges in surgical care","publication_year":2026,"publication_date":"2026-03-28","ids":{"openalex":"https://openalex.org/W7141522706","doi":"https://doi.org/10.1016/j.sipas.2026.100345","pmid":"https://pubmed.ncbi.nlm.nih.gov/42004647","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13084462"},"language":"en","primary_location":{"id":"doi:10.1016/j.sipas.2026.100345","doi":"https://doi.org/10.1016/j.sipas.2026.100345","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.sipas.2026.100345","pdf_url":null,"source":{"id":"https://openalex.org/S4210212132","display_name":"Surgery in Practice and Science","issn_l":"2666-2620","issn":["2666-2620"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","oarl"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Surgery in Practice and Science","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1016/j.sipas.2026.100345","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5041773241","display_name":"Pierre R. Tibi","orcid":"https://orcid.org/0009-0003-5331-7773","observed_orcids":["https://orcid.org/0009-0003-5331-7773"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Pierre R. Tibi","raw_affiliation_strings":["Department of Cardiothoracic and Vascular Services, Yavapai Regional Medical Center, 1003 Willow Creek Rd, Prescott, AZ 86301, USA"],"raw_orcid":"https://orcid.org/0009-0003-5331-7773","affiliations":[{"raw_affiliation_string":"Department of Cardiothoracic and Vascular Services, Yavapai Regional Medical Center, 1003 Willow Creek Rd, Prescott, AZ 86301, USA","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120246353","display_name":"Rory Tippit","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I99484792","display_name":"Baxter (United States)","ror":"https://ror.org/02d6ew870","country_code":"US","type":"company","lineage":["https://openalex.org/I99484792"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Rory Tippit","raw_affiliation_strings":["Medical Affairs Advanced Surgery, Worldwide Medical Affairs, Baxter Healthcare Corporation, 1 Baxter Parkway, Deerfield, IL 60015, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Medical Affairs Advanced Surgery, Worldwide Medical Affairs, Baxter Healthcare Corporation, 1 Baxter Parkway, Deerfield, IL 60015, USA","institution_ids":["https://openalex.org/I99484792"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037473329","display_name":"Stephen M. Dierks","orcid":"https://orcid.org/0009-0006-1048-2471","observed_orcids":["https://orcid.org/0009-0006-1048-2471"]},"institutions":[{"id":"https://openalex.org/I99484792","display_name":"Baxter (United States)","ror":"https://ror.org/02d6ew870","country_code":"US","type":"company","lineage":["https://openalex.org/I99484792"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Stephen M. Dierks","raw_affiliation_strings":["Medical Affairs Advanced Surgery, Worldwide Medical Affairs, Baxter Healthcare Corporation, 1 Baxter Parkway, Deerfield, IL 60015, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Medical Affairs Advanced Surgery, Worldwide Medical Affairs, Baxter Healthcare Corporation, 1 Baxter Parkway, Deerfield, IL 60015, USA","institution_ids":["https://openalex.org/I99484792"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5130797030","display_name":"Natalia Peres Martinez","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I99484792","display_name":"Baxter (United States)","ror":"https://ror.org/02d6ew870","country_code":"US","type":"company","lineage":["https://openalex.org/I99484792"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Natalia Peres Martinez","raw_affiliation_strings":["Medical Affairs Advanced Surgery, Worldwide Medical Affairs, Baxter Healthcare Corporation, 1 Baxter Parkway, Deerfield, IL 60015, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Medical Affairs Advanced Surgery, Worldwide Medical Affairs, Baxter Healthcare Corporation, 1 Baxter Parkway, Deerfield, IL 60015, USA","institution_ids":["https://openalex.org/I99484792"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5041773241"],"corresponding_institution_ids":[],"apc_list":{"value":2020,"currency":"USD","value_usd":2020},"apc_paid":{"value":2020,"currency":"USD","value_usd":2020},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"25","issue":null,"first_page":"100345","last_page":"100345"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10693","display_name":"Blood transfusion and management","score":0.6582000255584717,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10693","display_name":"Blood transfusion and management","score":0.6582000255584717,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12548","display_name":"Hemostasis and retained surgical items","score":0.29789999127388,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11930","display_name":"Cardiac, Anesthesia and Surgical Outcomes","score":0.006800000090152025,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/topical-hemostatic-agents","display_name":"topical hemostatic agents","score":0.9240000247955322},{"id":"https://openalex.org/keywords/anticoagulant-use","display_name":"anticoagulant use","score":0.6909999847412109},{"id":"https://openalex.org/keywords/charlson-comorbidity-index","display_name":"Charlson Comorbidity Index","score":0.9520000219345093},{"id":"https://openalex.org/keywords/patient-complexity","display_name":"patient complexity","score":0.8679999709129333},{"id":"https://openalex.org/keywords/elderly-patients","display_name":"elderly patients","score":0.40299999713897705},{"id":"https://openalex.org/keywords/chronic-comorbidities","display_name":"chronic comorbidities","score":0.7360000014305115},{"id":"https://openalex.org/keywords/thromboembolic-risk","display_name":"thromboembolic risk","score":0.7480000257492065},{"id":"https://openalex.org/keywords/surgical-specialties","display_name":"surgical specialties","score":0.4359999895095825},{"id":"https://openalex.org/keywords/cardiovascular-surgery","display_name":"cardiovascular surgery","score":0.8360000252723694},{"id":"https://openalex.org/keywords/neurosurgery","display_name":"neurosurgery","score":0.6790000200271606},{"id":"https://openalex.org/keywords/spine-surgery","display_name":"spinal surgery","score":0.7919999957084656}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8398000001907349},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.642799973487854},{"id":"https://openalex.org/C31174226","wikidata":"https://www.wikidata.org/wiki/Q64855140","display_name":"Perioperative","level":2,"score":0.505299985408783},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.43299999833106995},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.41200000047683716},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.33469998836517334},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3176000118255615},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.3156000077724457},{"id":"https://openalex.org/C2989236134","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Patient care","level":2,"score":0.31189998984336853},{"id":"https://openalex.org/C3019611579","wikidata":"https://www.wikidata.org/wiki/Q6641956","display_name":"Surgical procedures","level":2,"score":0.3018999993801117},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.2784999907016754},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.2587999999523163}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.1016/j.sipas.2026.100345","doi":"https://doi.org/10.1016/j.sipas.2026.100345","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.sipas.2026.100345","pdf_url":null,"source":{"id":"https://openalex.org/S4210212132","display_name":"Surgery in Practice and Science","issn_l":"2666-2620","issn":["2666-2620"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","oarl"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Surgery in Practice and Science","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13084462","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13084462/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13084462/pdf/main.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Surg Pract Sci","raw_type":"Text"},{"id":"pmid:42004647","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42004647","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Surgery in practice and science","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:312fe992f223421d905dd86c2b69ea0a","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/312fe992f223421d905dd86c2b69ea0a","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Surgery in Practice and Science, Vol 25, Iss , Pp 100345- (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1016/j.sipas.2026.100345","doi":"https://doi.org/10.1016/j.sipas.2026.100345","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.sipas.2026.100345","pdf_url":null,"source":{"id":"https://openalex.org/S4210212132","display_name":"Surgery in Practice and Science","issn_l":"2666-2620","issn":["2666-2620"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","jufo-1","ki-jl-1","norway-1","oarl"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Surgery in Practice and Science","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320332558","display_name":"Baxter Healthcare Corporation","ror":"https://ror.org/02d6ew870"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7141522706.pdf","grobid_xml":"https://content.openalex.org/works/W7141522706.grobid-xml"},"referenced_works_count":29,"referenced_works":["https://openalex.org/W974385733","https://openalex.org/W1985103534","https://openalex.org/W2053821268","https://openalex.org/W2091817958","https://openalex.org/W2160737535","https://openalex.org/W2161376212","https://openalex.org/W2296050385","https://openalex.org/W2487407743","https://openalex.org/W2765764881","https://openalex.org/W2889122693","https://openalex.org/W2891984252","https://openalex.org/W2999513238","https://openalex.org/W3039182524","https://openalex.org/W3097551159","https://openalex.org/W3109237526","https://openalex.org/W3154853139","https://openalex.org/W4200075130","https://openalex.org/W4205594133","https://openalex.org/W4220774232","https://openalex.org/W4292026545","https://openalex.org/W4309004811","https://openalex.org/W4313544826","https://openalex.org/W4383755451","https://openalex.org/W4387232273","https://openalex.org/W4387742518","https://openalex.org/W4390858379","https://openalex.org/W4396973129","https://openalex.org/W4400262317","https://openalex.org/W4403528956"],"related_works":["https://openalex.org/W2896069458","https://openalex.org/W4400205019","https://openalex.org/W2069346321","https://openalex.org/W2979396489","https://openalex.org/W4379645828","https://openalex.org/W4200445334","https://openalex.org/W4402405343","https://openalex.org/W2766009938","https://openalex.org/W2913352295","https://openalex.org/W7162966917"],"abstract_inverted_index":{"Introduction:":[0],"Medical":[1],"innovations":[2],"have":[3],"extended":[4],"patient":[5,85,186,223],"lifespans":[6],"while":[7,43,152],"also":[8],"increasing":[9],"the":[10,72,116,146,252],"clinical":[11,253],"complexity":[12,86],"associated":[13,62,207,229],"with":[14,33,115,136,208],"aging":[15],"and":[16,49,61,95,128,154,177,190,228,245],"chronic":[17],"conditions.":[18],"As":[19],"patients":[20,32],"live":[21],"longer,":[22],"surgeons":[23],"may":[24,246],"encounter":[25],"an":[26],"array":[27],"of":[28,126,165,193,231,255],"perioperative":[29,58],"challenges":[30,65],"including":[31],"multiple":[34],"comorbidities.":[35],"Consequently,":[36],"surgical":[37,63,82,113,140,198,235,259],"teams":[38],"must":[39],"manage":[40],"bleeding":[41,59],"risks":[42],"balancing":[44],"potential":[45],"thromboembolic":[46],"complications.":[47],"Material":[48],"Methods:":[50],"This":[51,217],"retrospective":[52,219],"observational":[53],"study":[54],"evaluated":[55],"trends":[56],"in":[57,119,160,174,257],"management":[60],"care":[64],"over":[66,237],"22":[67],"years,":[68],"utilizing":[69],"data":[70],"from":[71],"Premier":[73],"Perspective":[74],"Hospital":[75],"Database.":[76],"The":[77],"analysis":[78,181,220],"included":[79],"13,358,404":[80],"adult":[81],"patients,":[83],"examining":[84],"via":[87],"Charlson":[88],"Comorbidity":[89],"Index":[90],"(CCI),":[91],"preoperative":[92,124],"anticoagulant/antiplatelet":[93,161,188],"usage,":[94],"topical":[96],"hemostatic":[97],"agent":[98],"(THA)":[99],"utilization.":[100],"Results:":[101],"Patient":[102],"complexity,":[103,187,224],"as":[104],"indicated":[105],"by":[106,131,169],"CCI,":[107],"significantly":[108],"increased":[109,168],"annually":[110],"across":[111,139,196,234],"all":[112],"types,":[114],"greatest":[117],"increase":[118,149],"cardiovascular":[120,178],"surgery":[121,144],"(0.029/year).":[122],"Overall":[123],"use":[125,164,192,230],"anticoagulants":[127],"antiplatelets":[129],"rose":[130],"0.5":[132],"%":[133,171],"per":[134],"year,":[135],"marked":[137],"variations":[138],"cohorts.":[141],"Notably,":[142],"general":[143],"exhibited":[145],"highest":[147],"annual":[148],"(2.0":[150],"%),":[151],"knee":[153],"hip":[155],"replacements":[156],"showed":[157],"a":[158],"decline":[159],"use.":[162],"Overall,":[163],"THA":[166,194,209,232],"strategies":[167,195,233],"0.56":[170],"annually,":[172],"particularly":[173],"neurosurgery,":[175],"spinal,":[176],"procedures.":[179,215],"Multivariate":[180],"demonstrated":[182],"significant":[183],"associations":[184],"between":[185],"use,":[189,227],"higher":[191],"various":[197],"disciplines.":[199],"Elective":[200],"surgeries":[201],"were":[202],"more":[203],"likely":[204],"to":[205],"be":[206],"charges":[210],"than":[211],"emergent":[212],"or":[213],"urgent":[214],"Conclusions:":[216],"large":[218],"describes":[221],"evolving":[222],"antithrombotic":[225],"medication":[226],"specialties":[236],"two":[238],"decades.":[239],"These":[240],"findings":[241],"characterize":[242],"practice":[243],"patterns":[244],"inform":[247],"future":[248],"hypothesis-driven":[249],"studies":[250],"evaluating":[251],"role":[254],"THAs":[256],"different":[258],"contexts.":[260]},"counts_by_year":[],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-03-28T00:00:00"}
