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Perioperative anemia is associated with higher risk of red blood cell transfusion, higher rates of morbimortality and lower quality of postoperative recovery. In a context of focussing on higher quality management and improved recovery after surgery, development of Patient Blood management has increased. This study aim to assess PBM protocole in a postoperative context of gynaecological surgery, by comparing indicators at two time periods: 2 and 8 months after establishment of PBM protocol.
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| Measure | Description | Time Frame |
|---|---|---|
| rate of immediate pre operative anemia | preoperative Hb<13g/dL | at 2 and 8 months after establishment of PBM protocol |
| Measure | Description | Time Frame |
|---|---|---|
| rate of preoperative anemia that need to be treated diagnosed during anesthetic consultation | Hb<13 g/dL | at 2 and 8 months after establishment of PBM protocol |
| rate of Hemoglobin dosage available during anesthetic evaluation |
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Inclusion Criteria:
Exclusion Criteria:
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patient with planned surgery of hyterectomy or cancer related ovariectomy
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sigismond Lasocki | Contact | 0241353635 | +33 | SiLasocki@chu-angers.fr |
| Elise Houssin | Contact | 02 41 35 36 37 | +33 | DRCI-Promotion-Interne@chu-angers.fr |
| Name | Affiliation | Role |
|---|---|---|
| Sigismond Lasocki | University Hospital, Angers | Principal Investigator |
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| ID | Term |
|---|---|
| D000740 | Anemia |
| ID | Term |
|---|---|
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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number and rate of blood analyses
| at 2 and 8 months after establishment of PBM protocol |
| rate of preoperative iron deficiency that need to be treated diagnosed during anesthetic consultation | blood ferritin level <100 ng/mL | at 2 and 8 months after establishment of PBM protocol |
| adequacy between diagnosed iron deficiency anemia and treatment | rate of iron prescription | at 2 and 8 months after establishment of PBM protocol |
| effectiveness of iron treatment | rate of persistent pre operative anemia after iron treatment | at 2 and 8 months after establishment of PBM protocol |
| immediat effect of surgery on anemia incidence | rate of post operative anemia (Hb<12g/dL)/ rate of post operative iron treatment | at 2 and 8 months after establishment of PBM protocol |
| delayed effect of surgery on anemia incidence | rate of delayed post operative anemia or iron deficiency | at 2 and 8 months after establishment of PBM protocol |
| early post operative recovery | FQoR 15 on the day of hospital dischage | at 2 and 8 months after establishment of PBM protocol |
| delayed post operative recovery | FQoR 15 at the post operative surgical visit | at 2 and 8 months after establishment of PBM protocol |
| adhesion to PBM protocol (rate of anemia) | comparison of rate of anemia screening | at 2 and 8 months after establishment of PBM protocol |
| efficiency of PBM protocol (iron treatment rate) | comparison of iron treatment rate | at 2 and 8 months after establishment of PBM protocol |
| adhesion to PBM protocol (missing datas) | comparison of the rate of missing datas | at 2 and 8 months after establishment of PBM protocol |
| efficiency of PBM protocol (preoperative anemia rate) | comparison of the rate of preoperative anemia | at 2 and 8 months after establishment of PBM protocol |
| efficiency of PBM protocol (perioperative transfusion rate) | comparison of the rate of peri opeartive transfusion | at 2 and 8 months after establishment of PBM protocol |
| efficiency of PBM protocol (mean of FQoR-15) | comparison of the mean of FQoR-15 | at 2 and 8 months after establishment of PBM protocol |
| efficiency of PBM protocol (mean of FQoR-15 between patients with or without preoperative anemia) | comparison of FQoR-15 means between patients with or without preoperative anemia | at 2 and 8 months after establishment of PBM protocol |
| efficiency of PBM protocol (rate of screening anemia and the rate of preoperative anemia ) | comparison of the rate of screening anemia and the rate of preoperative anemia | at 2 and 8 months after establishment of PBM protocol |
| efficiency of PBM protocol (Hb level between anesthetic evaluation and pre anesthetic visit) | comparison of Hb level between anesthetic evaluation and pre anesthetic visit (paired T test) | at 2 and 8 months after establishment of PBM protocol |
| efficiency of PBM protocol (difference of hemoglobin level after iron treatment) | mean difference of hemoglobin level after iron treatment | at 2 and 8 months after establishment of PBM protocol |