Implementation of a Blood Management Program at a Tertiary Care Hospital: Effect on Transfusion Practices and Clinical Outcomes Among Patients Undergoing Surgery

Annals of Surgery
Faiz GaniTimothy M Pawlik

Abstract

Patient blood management (PBM) programs represent a perioperative bundle of care that aim to reduce or eliminate unnecessary transfusions. To evaluate the impact of a PBM program on transfusion practices and clinical outcomes at a single surgical department at a tertiary care hospital in the United States. This pre-post, cross-sectional study was performed using data from 17,114 patients undergoing gastrointestinal surgery between 2010 and 2013. Multivariable regression analysis was used to evaluate the impact of implementing a PBM program on transfusion practices and perioperative clinical outcomes. Implementation of the PBM program was associated with a reduction in the proportion of patients receiving packed red blood cell (PRBC) using a liberal trigger hemoglobin concentration (pre-PBM vs post-PBM: trigger ≥8.0 g/dL: 20.2% vs 15.3%, P < 0.001), as well as an increase in the proportion of patients receiving PRBC using a restrictive trigger hemoglobin concentration (trigger <7.0 g/dL: 37.1% vs 46.4%, P < 0.001). The proportion of patients overtransfused to a target hemoglobin concentration of 9.0 g/dL (54.8% vs 43.9%, P < 0.001) or 10.0 g/dL (22.3% vs 15.8%, P < 0.001) also decreased following implementation of the PBM progra...Continue Reading

References

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Citations

Mar 13, 2019·JAMA : the Journal of the American Medical Association·Markus M MuellerUNKNOWN ICC PBM Frankfurt 2018 Group
Apr 6, 2019·Minerva anestesiologica·Tetsuro Sakai, Gianni Biancofiore
Apr 4, 2020·Anesthesia and Analgesia·Aryeh ShanderUNKNOWN International Foundation of Patient Blood Management (IFPBM) and Society for the Advancement of Blood Management (SABM) Work

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