Saioa Zalba Marcos1, Inés Plaja Martí2, María Luisa Antelo Caamaño3, Javier Martínez de Morentin Garraza4, María Luisa Abinzano Guillén5, Elena Martín Rodríguez6, Alicia Aranguren Azparren1, Andrea Torres López1, Arkaitz Galbete Jiménez7, José Antonio García Erce8. 1. Servicio de Hematología y Hemoterapia, Complejo Hospitalario de Navarra, IDISNA, Pamplona, España. 2. Servicio de Anestesia, Hospital García Orcoyen, Estella, España. 3. Servicio de Hematología y Hemoterapia, Complejo Hospitalario de Navarra, IDISNA, Pamplona, España; Servicio de Apoyo a la Gestión Clínica y Calidad Asistencial, Complejo Hospitalario de Navarra, IDISNA, Pamplona, España. 4. Servicio de Cirugía Ortopédica y Traumatología, Hospital García Orcoyen, Estella, España. 5. Servicio de Medicina Interna, Hospital García Orcoyen, Estella, España. 6. Servicio de Análisis Clínicos, Hospital García Orcoyen, Estella, España. 7. Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), REDISSEC, Pamplona, España. 8. Banco de Sangre y Tejidos de Navarra, Servicio Navarro de Salud, Osasunbidea, Pamplona, España; Grupo de Trabajo de la Sociedad Española de Transfusión Sanguínea «Hemoterapia basada en sentido común», Jaca (Huesca), España; Grupo Español de Rehabilitación Multimodal (GERM). Instituto Aragonés de Ciencias de la Salud, Zaragoza, España; Grupo Multidisciplinar para el Estudio y Manejo de la Anemia del Paciente Quirúrgico (http://www.awge.org), Barcelona, España; Grupo idiPAZ de «Investigación en PBM», Madrid, España. Electronic address: ja.garcia.erce@navarra.es.
Abstract
BACKGROUND AND OBJECTIVES: The "Patient Blood Management" (PBM) programmes have demonstrated their value in the continuous improvement of care practice, due to continuous systematic reviewing of results and their dynamic and multidisciplinary updating in accordance with new clinical evidence. Our goal is to demonstrate the effectiveness of simple protocols, applicable in second level hospitals. PATIENTS AND METHODS: 702 patients undergoing scheduled arthroplasty from 2011 to 2018 were retrospectively analysed. During this period, the evolution of transfusion rates and anaemia and bleeding management were recorded in the patients' computerised clinical histories. RESULTS: Stages and transfusion rates were: Year 2011-2012, "Universal self-donation programme": 62.4%; year 2013, "Optimization of preoperative haemoglobin and universal self-donation withdrawal", 22.5%; year 2015, "Stopping the use of cell-savers and drains", 13.2%; and year 2017, "Introduction of routine tranexamic acid", 3.6%. A significant reduction in the transfusion rate and volume (P<.001) and the average hospital stay (8 to 6 days) (P<.001) was achieved. In multivariate models, transfused patients have a .5-day stay and there is a trend towards a reduction in complications, being fewer in patients receiving tranexamic acid (OR .44). CONCLUSION: A simple progressive and multidisciplinary PBM programme, with continued re-evaluation, has allowed a reduction in transfusion rates and average hospital stay.
BACKGROUND AND OBJECTIVES: The "Patient Blood Management" (PBM) programmes have demonstrated their value in the continuous improvement of care practice, due to continuous systematic reviewing of results and their dynamic and multidisciplinary updating in accordance with new clinical evidence. Our goal is to demonstrate the effectiveness of simple protocols, applicable in second level hospitals. PATIENTS AND METHODS: 702 patients undergoing scheduled arthroplasty from 2011 to 2018 were retrospectively analysed. During this period, the evolution of transfusion rates and anaemia and bleeding management were recorded in the patients' computerised clinical histories. RESULTS: Stages and transfusion rates were: Year 2011-2012, "Universal self-donation programme": 62.4%; year 2013, "Optimization of preoperative haemoglobin and universal self-donation withdrawal", 22.5%; year 2015, "Stopping the use of cell-savers and drains", 13.2%; and year 2017, "Introduction of routine tranexamic acid", 3.6%. A significant reduction in the transfusion rate and volume (P<.001) and the average hospital stay (8 to 6 days) (P<.001) was achieved. In multivariate models, transfused patients have a .5-day stay and there is a trend towards a reduction in complications, being fewer in patients receiving tranexamic acid (OR .44). CONCLUSION: A simple progressive and multidisciplinary PBM programme, with continued re-evaluation, has allowed a reduction in transfusion rates and average hospital stay.
Authors: J A García-Erce; C Jericó; A Abad-Motos; J Rodríguez García; M L Antelo Caamaño; J M Domingo Morera; C Sola Lapeña; J L Arroyo; F Fernández Fuertes; S Zalba Marcos; G Cerdán Rodríguez; M J Laso Morales; J L Bueno Cabrera; E Chica; V Recasens; A Zabalegui; E Balen; E Urrechaga; A Abad-Gurumeta; M Quintana Díaz Journal: Rev Esp Anestesiol Reanim (Engl Ed) Date: 2022-06-24
Authors: J A García-Erce; C Jericó; A Abad-Motos; J Rodríguez García; M L Antelo Caamaño; J M Domingo Morera; C Sola Lapeña; J L Arroyo; F Fernández Fuertes; S Zalba Marcos; G Cerdán Rodríguez; M J Laso Morales; J L Bueno Cabrera; E Chica; V Recasens; A Zabalegui; E Balen; E Urrechaga; A Abad-Gurrumenta; M Quintana Díaz Journal: Rev Esp Anestesiol Reanim (Engl Ed) Date: 2021-09-22
Authors: José Antonio García-Erce; Íñigo Romón-Alonso; Carlos Jericó; José María Domingo-Morera; José Luis Arroyo-Rodríguez; Carlos Sola-Lapeña; José Luis Bueno-Cabrera; Raúl Juárez-Vela; Saioa Zalba-Marcos; Ane Abad-Motos; Vicente Gea-Caballero; Iván Santolalla-Arnedo; Manuel Quintana-Díaz Journal: Int J Environ Res Public Health Date: 2021-03-27 Impact factor: 3.390