Dora García1, Ana Aguilera1, Francisco Antolín2, José-Luis Arroyo3, Miguel Lozano4, Pedro Sanroma1, Iñigo Romón5. 1. Department of Hospital at Home, Marqués de Valdecilla University Hospital, Santander, Spain. 2. Department of Preventive Medicine and Public Health, Marqués de Valdecilla University Hospital, Santander, Spain. 3. Blood and Tissue Bank of Cantabria, Santa Cruz Hospital, Liencres, Spain. 4. Department of Hemotherapy and Hemostasis, University Clinic Hospital, IDIBAPS, University of Barcelona, Barcelona, Spain. 5. Blood Transfusion Department, Marqués de Valdecilla University Hospital, IDIVAL, Santander, Spain.
Abstract
BACKGROUND: Hospital at Home (HH) provides specialized care at the patients' homes. Keeping patients in familial surroundings can result in better outcomes reducing readmission to hospital, mortality, and costs of care. Home transfusion (HT) can be a key element in HH management but is scarcely deployed due to concerns about safety and cost. We have reviewed our HT practice to assess its feasibility and safety. STUDY DESIGN AND METHODS: We prospectively reviewed data collected from 1985 to 2015, focusing specially on feasibility and procedural safety, looking for adverse events of transfusion. We also assessed the situation in similar hospitals in Spain with a survey about their practice. RESULTS: A total of 613 patients received 2260 blood components in 2126 transfusion episodes. A total of 93% patients received fewer than 10 transfusions. Most patients were treated for blood diseases (32%) or cancers (20%). The rate of adverse effects was 2.68% and decreased significantly with time. Fever was the most common adverse reaction. Patients who received transfusion of more than one blood product in a day were at higher risk of adverse events. No errors or near-miss events were detected, and no patient had to be readmitted to hospital for this cause. The survey on HT practices in similar hospitals showed great variation in practice. CONCLUSION: HT is feasible, sustainable, and safe, when performed on selected patients by dedicated HH units with well-trained staff, under specific protocols.
BACKGROUND: Hospital at Home (HH) provides specialized care at the patients' homes. Keeping patients in familial surroundings can result in better outcomes reducing readmission to hospital, mortality, and costs of care. Home transfusion (HT) can be a key element in HH management but is scarcely deployed due to concerns about safety and cost. We have reviewed our HT practice to assess its feasibility and safety. STUDY DESIGN AND METHODS: We prospectively reviewed data collected from 1985 to 2015, focusing specially on feasibility and procedural safety, looking for adverse events of transfusion. We also assessed the situation in similar hospitals in Spain with a survey about their practice. RESULTS: A total of 613 patients received 2260 blood components in 2126 transfusion episodes. A total of 93% patients received fewer than 10 transfusions. Most patients were treated for blood diseases (32%) or cancers (20%). The rate of adverse effects was 2.68% and decreased significantly with time. Fever was the most common adverse reaction. Patients who received transfusion of more than one blood product in a day were at higher risk of adverse events. No errors or near-miss events were detected, and no patient had to be readmitted to hospital for this cause. The survey on HT practices in similar hospitals showed great variation in practice. CONCLUSION:HT is feasible, sustainable, and safe, when performed on selected patients by dedicated HH units with well-trained staff, under specific protocols.
Authors: Arwa Z Al-Riyami; Lise Estcourt; Naomi Rahimi-Levene; Evan M Bloch; Ruchika Goel; Pierre Tiberghien; Jean-Baptiste Thibert; Mie Topholm Bruun; Dana V Devine; Richard R Gammon; Silvano Wendel; Michel Toungouz Nevessignsky; Rada M Grubovic Rastvorceva; Adaeze Oreh; Iñigo Romon; Karin van den Berg; Junichi Kitazawa; Gopal Patidar; Cynthia So-Osman; Erica M Wood Journal: Vox Sang Date: 2022-09-14 Impact factor: 2.996