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Retrospective observational study: impact of a peri-operative patient blood management program (PBM) on transfusion rates of patients undergoing elective hip replacement.
A Patient Blood Management (PBM) program was implemented in year 2019 in our institution: patient scheduled for elective total hip replacement underwent pre-operative screening about one month before surgery, and those with pre-operative hemoglobin < 13 g/dl were screened for possible causes and treatment of anemia.
Data from two different time frames, before and after the implementation of the program, were collected to study the change in clinical outcomes such as transfusion rates, length of stay, etc.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pre-PBM | patients screened for surgery before the implementation of PBM program: pre-operative evaluation and treatment according to usual care | ||
| post-PBM | patients screened for surgery after the implementation of PBM program (3 months allowed for training/optimization): all patients with pre-operative hemoglobin < 13g/dl undergo screening for causes and treatment as needed. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| evaluation by transfusion medicine specialist | Combination Product | screening for anemia causes and treatment: iron/folate/vitamin B12 supplementation, Erythropoietin administration if indicated |
| Measure | Description | Time Frame |
|---|---|---|
| transfusion rates | percentage of patients undergoing hip replacement who receive at least one unit of concentrated red cells during or after surgery | from day of surgery till day of discharge, up to 60 days |
| Measure | Description | Time Frame |
|---|---|---|
| minimum hemoglobin | minimum hemoglobin reached after surgery | from day of surgery till day of discharge, up to 60 days |
| hemoglobin at discharge | last measured hemoglobin before discharge from hospital |
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Inclusion Criteria:
Exclusion Criteria:
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All patients of age > 18 who undergo screening and surgery for hip athroplasty in the selected time-frame
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| Name | Affiliation | Role |
|---|---|---|
| Stefano Bonarelli, MD | Istituto Ortopedico Rizzoli | Principal Investigator |
| Sandra Giannone, MD | Istituto Ortopedico Rizzoli | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sandra Giannone | Bologna | BO | 40128 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29944518 | Background | Ellermann I, Bueckmann A, Eveslage M, Buddendick H, Latal T, Niehoff D, Geissler RG, Hempel G, Kerkhoff A, Berdel WE, Roeder N, Van Aken HK, Zarbock A, Steinbicker AU. Treating Anemia in the Preanesthesia Assessment Clinic: Results of a Retrospective Evaluation. Anesth Analg. 2018 Nov;127(5):1202-1210. doi: 10.1213/ANE.0000000000003583. | |
| 27996086 |
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| ID | Term |
|---|---|
| D000740 | Anemia |
| D004194 | Disease |
| D018798 | Anemia, Iron-Deficiency |
| ID | Term |
|---|---|
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| from day of surgery till day of discharge, up to 60 days |
| length of stay | total days of hospital stay from admission to discharge | from day of surgery till day of discharge, up to 60 days |
| Munoz M, Acheson AG, Auerbach M, Besser M, Habler O, Kehlet H, Liumbruno GM, Lasocki S, Meybohm P, Rao Baikady R, Richards T, Shander A, So-Osman C, Spahn DR, Klein AA. International consensus statement on the peri-operative management of anaemia and iron deficiency. Anaesthesia. 2017 Feb;72(2):233-247. doi: 10.1111/anae.13773. Epub 2016 Dec 20. |
| 26748489 | Background | Rineau E, Chaudet A, Chassier C, Bizot P, Lasocki S. Implementing a blood management protocol during the entire perioperative period allows a reduction in transfusion rate in major orthopedic surgery: a before-after study. Transfusion. 2016 Mar;56(3):673-81. doi: 10.1111/trf.13468. Epub 2016 Jan 8. |
| D000747 | Anemia, Hypochromic |
| D000090463 | Iron Deficiencies |
| D019189 | Iron Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |