This phenotype will look for the below concepts between Anesthesia Start and Anesthesia End.  All infusions running beyond Anestheisa will be totaled for this phenotype at Anesthesia End.

Each case will return four results for this phenotype:

- Total Volume in Units

- Total Volume in Milliliters

- Autologous Volume in Units

- Autologous Total Volume in Milliliters

- Homolgous volume in Units

- Homolgous total Volume in Milliliters

- Unknown volume in Units

- Unknown total Volume in Milliliters

- Source documentation type (numeric code to indicate how the original values were reported to MPOG as units, milliliters or both)

- Source documentation description (actual description of how the original values were reported to MPOG, i.e. units, milliliters, or both)

Artifact Logic:

Step 1: Check if the case has documented mL value of "9999" and ignore these values.

Step 2: Remove the mL administrations for cases where all of the below statements are true.

• The case has 1 or more non mL administrations or rate and 1 or more mL amounts
• The non mL or rate dose and the mL administrations must have the same AIMS ID
• The non mL or rate dose and the mL administrations must have the same MPOG Route Concept.

Calculation:

Step 1: Determine if the case has any of the PRBC concepts listed above and with administration start time(s) between anesthesia start and anesthesia end.

a) If none, return:                

1) Volume in units: 0

2) Volume in milliliters: 0

3) Source documentation type: 0

4) Source documentation Description: “No PRBCs Documented in Case”

b) If 1 or more PRBC concepts are identified, continue to step 2.

Step 2: Convert any time based units (units/hr or ml/hr) to full non-time based units (units or ml) + round to whole number, move to step 3. If no end time documented, will use anesthesia end time as the end time for the transfusion.

Step 3: Generate case totals + indicator flags:

Step 3a) If charting is exclusively in ml’s, continue with step 3a, part i. Else, skip to step 3b.

i) Sum all volumes to generate a milliliter value and proceed to step 3, part ii.

ii) If patient age is >8 years, divide total milliliter value by 350 and round to the nearest whole number. Evaluate if value is greater than 150 units. (If patient age <8, move to step 3a, part iii.)

1) If no, return:

a) Volume in units: Calculated value from step 3a, part ii

b) Volume in milliliters: Calculated value from step 3a, part i

c) Source documentation type: 1

d) Source documentation description: 'PRBCs Documented in milliliters'

2) If yes, return:

a) Volume in units: 'null'

b) Volume in milliliters: 'null'

c) Source documentation type: 8

d) Source documentation description: 'Unable to derive data - extremely high charted values'

iii) If patient age < 8 years, return:

a) Volume in units: 'null'

b) Volume in milliliters: calculated value from step 3a, part i.

c) Source documentation type: 1

d) Source documentation description: 'PRBCs documented in milliliters'

Step 3b: If charting is exclusively in Units, continue with step 3b, part i. Else, skip to step 3c.

i) If patient age < 8 years, return the following:

a) Volume in units: 'null'

b) Volume in milliliters: 'null'

c) Source Documentation type: 9

d) Source Documentation description: 'Unable to retrieve data - patient age'

ii) If patient age =8 years, sum all volumes to generate a unit value. Evaluate if value is greater than 150 units.

a) If yes, return:

1) Volume in units: 'null'

2) Volume in milliliters: 'null'

3) Source documentation type: 8

4) Source documentation description: 'Unable to derive data - Extremely High Charted Values'

b) If no, return calculated value of 'volume in units' and proceed to step 3b, part iii.

iii) Multiply unit value from step 3b, part i by 350, return calculated value for 'volume in ml.' Proceed to step 3b part iv.

iv) Return Source Documentation Type: 2 

v) Return Source Documentation Description: 'PRBCs documented in units'

Step 3c. If charting is documented in both units and milliliters and patient age = 8 years, proceed to step 3c, part i. If patient age is < 8 years, skip to step 3d.

i) Sum all volumes reported in units, move to ii.

ii) Sum all volumes reported in milliliters, move to iii.

iii) Divide volumes in milliliters (from step ii) by 350, round, add to raw unit value from step i. Evaluate if value is greater than 150 units. 

1) If yes, return:

a) Volume in units: 'null'

b) Volume in milliliters: 'null'

c) Source documentation type: 8

d) Source documentation description: 'Unable to derive data - extrememly high charted values'

2) If no, return the calculated unit value for 'Volume in units.' Proceed to step 3c, part iv.

iv) Multiply volume in units (from step i) by 350, round, add to raw ml value from step ii. Return calculated milliliter value in 'Volume in milliliter' Proceed to step 3c, part v.

v) Return Source Documentation Type: 3

vi) Return Source Documentation Description: 'PRBCs documented in both units and milliliters'

Step 3d. If charting is both in units and milliliters and patient age is < 8 years, proceed to step 3d, part i.

i) Return Volume in Units: 'null'

ii) Return Volume in Milliliters: 'null'

iii) Return Source Documentation Type: 9

iv) Return Source Documentation Description: 'Unable to derive data - patient age'