Dilek Unal1, Yesim Senayli2, Reyhan Polat1, Donat R Spahn3, Fevzı Toraman4, Neslıhan Alkis5, Alanoglu Zekeriyya5, Aydinli Bahar6, Bermede Ahmet Onat5, Bilgin Hulya7, Buget Mehmet8, Coskunfirat Nesil9, Demir Asli10, Goren Suna7, Guner Can Meltem11, Orhan Mukadder8, Senturk Mert8, Tezcan Busra10, Toprak Huseyin Ilksen12, Yildirim Guclu Cigdem5, Abitagaoglu Suheyla13, Abut Yesim14, Akdaglı Ekici Arzu15, Akdas Tekin Esra16, Akdogan Ali17, Akin Mine18, Akovali Nukhet19, Aksoy Semsi Mustafa20, Alaygut Ergin21, Arar Makbule Cavidan22, Arican Sule23, Arici Ayse Gulbin9, Arik Emine1, Arik Esma24, Arslan Mahmut25, Ay Necmiye26, Aykac Zuhal27, Ayoglu Hilal28, Basaran Cumhur29, Baytas Volkan5, Bedirli Nurdan24, Bestas Azize30, Bigat Zekiye9, Bilgin Mehmet Ugur31, Boran Omer Faruk25, Buyukcoban Sibel32, Cakar Turhan Sanem5, Cakmak Meltem21, Cankaya Baris27, Capar Ayse33, Cebeci Zubeyir34, Cetinkaya Ethemoglu Filiz Banu35, Cicekci Faruk36, Colak Alkin37, Colak Yusuf Ziya12, Dagli Esra16, Demir Hafize Fisun38, Derbent Abdurrahim26, Dumanlı Ozcan Ayca20, Ekinci Osman39, Erdogan Kayhan Gulay40, Erturk Engin17, Erus Ipek41, Esen Tekeli Arzu42, Gamli Mehmet43, Gulel Basak1, Gulgun Gamze44, Gunduz Emel9, Gunes Isin45, Guven Aytac Betul46, Hacibeyoglu Gulcin23, Has Selmi Nazan47, Ilgaz Kocyigit Ozgen48, Ilksen Egilmez Ayse49, Iyigun Muzeyyen48, Kara Inci36, Karakaya Deniz50, Karasu Derya43, Karaveli Arzu51, Kavas Ayse Duygu41, Kaya Mensure52, Kaya Suleyman20, Kazak Bengisun Zuleyha53, Keskin Gulsen18, Kilci Oya47, Kilic Yeliz40, Kirdemir Pakize54, Koc Zeynep33, Koksal Ceren13, Kozanhan Betul49, Kucukguclu Semih32, Kucukosman Gamze28, Kupeli Ilke55, Kurtay Aysun56, Kurtipek Omer24, Meco Basak Ceyda5, Nalbant Burak1, Okyay Rahsan Dilek28, Omur Dilek32, Orak Yavuz25, Ounde Elif39, Özayar Esra56, Ozcelik Menekse5, Ozden Eyup Sabri54, Ozer Yetkin57, Ozgok Aysegul10, Ozhan Mehmet Ozgur58, Ozlu Onur59, Sagir Ozlem38, Saglik Arzu33, Sagun Aslinur60, Sahap Mehmet56, Sahin Cihan59, Sahiner Yeliz15, Salman Nevriye10, Saracoglu Ayten27, Saracoglu Kemal Tolga61, Sarizeybek Hilal62, Selcuk Sert Gokce10, Sen Betul63, Sen Ozlem52, Sener Elif Bengi50, Sengul Fatma Isil51, Silay Emin33, Subası Ferhunde Dilek39, Tarikci Kilic Ebru41, Tas Nilay34, Tekgul Zeki Tuncel31, Tekgunduz Sibel64, Tezcan Keles Gonul65, Topcu Hulya15, Tunay Abdurrahman14, Ugun Fatih38, Un Canan47, Unal Petek39, Unver Suheyla52, Ural Sedef Gulcin66, Uzumcugil Filiz67, Yerebakan Akesen Selcan7, Yesildal Kadir16, Yildirim Mustafa1, Yildiz Altun Aysun30, Yildiz Munise49, Yilmaz Erisen Hatice21, Yilmaz Hakan53, Yilmaz Mehmet62, Yuzkat Nureddin68. 1. Department of Anaesthesiology and Reanimation, University of Health Sciences Diskapi Yildirim Beyazit Teaching Hospital, Ankara, Turkey. 2. Department of Anaesthesiology and Reanimation, "Ankara Gulhane" Teaching Hospital, Ankara, Turkey. 3. Institute of Anaesthesiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland. 4. Department of Anaesthesiology, "Acibadem Mehmet Ali Aydınlar" University School of Medicine, Istanbul, Turkey. 5. Department of Anaesthesiology and Reanimation, Ankara University Medical Faculty, Ankara, Turkey. 6. Department of Anaesthesiology and Reanimation, Mersin City Hospital, Mersin, Turkey. 7. Department of Anaesthesiology and Reanimation, Bursa Uludag University Medical Faculty, Bursa, Turkey. 8. Department of Anaesthesiology, Istanbul University Medical Faculty, Istanbul, Turkey. 9. Department of Anaesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey. 10. Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara City Hospital, Ankara, Turkey. 11. Department of Anaesthesiology and Reanimation, Acibadem Mehmet Ali Aydınlar University School of Medicine, Atakent Hospital, Istanbul, Turkey. 12. Department of Anaesthesiology, Inonu University Liver Transplantation Institute, Malatya, Turkey. 13. Department of Anaesthesiology and Reanimation, University of Health Sciences Fatih Sultan Mehmet Teaching Hospital, Istanbul, Turkey. 14. Department of Anaesthesiology and Reanimation, University of Health Sciences Istanbul Teaching Hospital, Istanbul, Turkey. 15. Department of Anaesthesiology and Reanimation, Hitit University, School of Medicine, Corum Erol Olcok Teaching Hospital, Corum, Turkey. 16. Department of Anaesthesiology and Reanimation, University of Health Sciences Okmeydanı Teaching Hospital, Istanbul, Turkey. 17. Department of Anaesthesiology and Reanimation, Karadeniz Technical University Medical Faculty Farabi Hospital, Trabzon, Turkey. 18. Department of Anaesthesiology, University of Health Sciences Ankara Child Health and Diseases Hematology Oncology Teaching Hospital, Ankara, Turkey. 19. Department of Anaesthesiology and Reanimation, Baskent University Medical Faculty Ankara Hospital, Ankara, Turkey. 20. Department of Anaesthesiology and Reanimation, Ankara Ataturk Teaching Hospital, Ankara, Turkey. 21. Department of Anaesthesiology and Reanimation, University of Health Sciences Izmir Tepecik Teaching Hospital, Izmir, Turkey. 22. Department of Anaesthesiology and Reanimation, Namık Kemal University Medical Faculty, Tekirdag, Turkey. 23. Department of Anaesthesiology and Reanimation, Necmettin Erbakan University Meram Medical Faculty, Konya, Turkey. 24. Department of Anaesthesiology and Reanimation, Gazi University Medical Faculty, Ankara, Turkey. 25. Department of Anaesthesiology and Reanimation, Sutcu Imam University Medical Faculty, Kahramanmaraş, Turkey. 26. Department of Anaesthesiology and Reanimation, University of Health Sciences Kanuni Sultan Suleyman Teaching Hospital, Istanbul, Turkey. 27. Department of Anaesthesiology and Reanimation, Marmara University Pendik Teaching Hospital, Istanbul, Turkey. 28. Department of Anaesthesiology and Reanimation, Zonguldak Bulent Ecevit University Medical Faculty Center for Health and Research, Zonguldak, Turkey. 29. Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara Teaching Hospital, Ankara, Turkey. 30. Department of Anaesthesiology and Reanimation, Fırat University Medical Faculty, Elazıg, Turkey. 31. Department of Anaesthesiology and Reanimation, University of Health Sciences Izmir Bozyaka Teaching Hospital, Izmir, Turkey. 32. Department of Anaesthesiology and Reanimation, Dokuz Eylul University Medical Faculty, Izmir, Turkey. 33. Department of Anaesthesiology and Reanimation, University of Health Sciences Kayseri Teaching Hospital, Kayseri, Turkey. 34. Department of Anaesthesiology and Reanimation, Ordu University Medical Faculty, Ordu, Turkey. 35. Department of Anaesthesiology and Reanimation, Yenimahalle Teaching Hospital, Ankara, Turkey. 36. Department of Anaesthesiology and Reanimation, Selcuk University Medical Faculty, Konya, Turkey. 37. Department of Anaesthesiology and Reanimation, Trakya University Medical Faculty, Edirne, Turkey. 38. Department of Anaesthesiology and Reanimation, Balikesir University Medical Faculty Teaching Hospital, Balıkesir, Turkey. 39. Department of Anaesthesiology and Reanimation, University of Health Sciences Haydarpasa Numune Teaching Hospital, Istanbul, Turkey. 40. Department of Anaesthesiology and Reanimation, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey. 41. Department of Anaesthesiology and Reanimation, University of Health Sciences Umraniye Teaching Hospital, Istanbul, Turkey. 42. Department of Anaesthesiology and Reanimation, Van Yuzuncu yil University Medical Faculty Dursun Odabası Medical Center, Van, Turkey. 43. Department of Anaesthesiology and Reanimation, University of Health Sciences Yuksek Ihtisas Teaching Hospital, Bursa, Turkey. 44. Department of Anaesthesiology and Reanimation, Tunceli State Hospital, Tunceli, Turkey. 45. Department of Anaesthesiology and Reanimation, Erciyes University, Medical Faculty, Kayseri, Turkey. 46. Department of Anaesthesiology, University of Health Sciences Etlik Zubeyde Hanim Gynecology and Obstetrics Teaching Hospital, Ankara, Turkey. 47. Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara Numune Teaching Hospital, Ankara, Turkey. 48. Department of Anaesthesiology and Reanimation, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Atakent Hospital, Istanbul, Turkey. 49. Department of Anaesthesiology and Reanimation, University of Health Sciences Konya Teaching Hospital, Konya, Turkey. 50. Department of Anaesthesiology and Reanimation, Ondokuz Mayis University Medical Faculty, Samsun, Turkey. 51. Department of Anaesthesiology and Reanimation, University of Health Sciences Antalya Teaching Hospital, Antalya, Turkey. 52. Department of Anaesthesiology and Reanimation, University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Teaching Hospital, Ankara, Turkey. 53. Department of Anaesthesiology and Reanimation, Ufuk University School of Medicine, Ankara, Turkey. 54. Department of Anaesthesiology and Reanimation, Suleyman Demirel University Medical Faculty, Isparta, Turkey. 55. Department of Anaesthesiology and Reanimation, Ministry of Health Erzincan University Mengucek Gazi Teaching Hospital, Erzincan, Turkey. 56. Department of Anaesthesiology and Reanimation, University of Health Sciences Kecioren Teaching Hospital, Ankara, Turkey. 57. Department of Anaesthesiology and Reanimation, Anadolu Health Center, Istanbul, Turkey. 58. Department of Anaesthesiology and Reanimation, Private Cankaya Hospital, Ankara, Turkey. 59. Department of Anaesthesiology, University of Economics and Technology, Medical Faculty Hospital, Ankara, Turkey. 60. Department of Anaesthesiology and Reanimation, Mersin University Medical Faculty, Mersin, Turkey. 61. Department of Anaesthesiology and Reanimation, University of Health Sciences Kartal Dr. Lutfi Kirdar Teaching Hospital, Istanbul, Turkey. 62. Department of Anaesthesiology and Reanimation, University of Health Sciences Derince Teaching Hospital, Kocaeli, Turkey. 63. Department of Anaesthesiology and Reanimation, Istanbul Medeniyet University Goztepe Teaching Hospital, Istanbul, Turkey. 64. Department of Child Health and Diseases, University of Health Sciences Kecioren Teaching Hospital, Ankara, Turkey. 65. Department of Anaesthesiology and Reanimation, Manisa Celal Bayar University Medical Faculty Hafsa Sultan Hospital, Manisa, Turkey. 66. Department of Anaesthesiology and Reanimation, Osmaniye State Hospital, Osmaniye, Turkey. 67. Department of Anaesthesiology and Reanimation, Hacettepe University School of Medicine, Ankara, Turkey. 68. Department of Anaesthesiology and Reanimation, Van Yuzuncu Yil University Medical Faculty Dursun Odabası Medical Center, Van, Turkey.
Abstract
BACKGROUND: Patients' demographic and epidemiological characteristics, local variations in clinicians' knowledge and experience and types of surgery can influence peri-operative transfusion practices. Sharing data on transfusion practices and recipients may improve patients' care and implementation of Patient Blood Management (PBM). MATERIALS AND METHODS: This was a multicentre, prospective, observational, cross-sectional study that included 61 centres. Clinical and transfusion data of patients undergoing major elective surgery were collected; transfusion predictors and patients' outcomes were analysed. RESULTS: Of 6,121 patients, 1,579 (25.8%) received a peri-operative transfusion. A total of 5,812 blood components were transfused: red blood cells (RBC), fresh-frozen plasma and platelets in 1,425 (23.3%), 762 (12.4%) and 88 (1.4%) cases, respectively). Pre-operative anaemia was identified in 2,019 (33%) patients. Half of the RBC units were used by patients in the age group 45-69 years. Specific procedures with the highest RBC use were coronary artery bypass grafting (16.9% of all units) and hip arthroplasty (14.9%). Low haemoglobin concentration was the most common indication for intra-operative RBC transfusion (57%) and plasma and platelet transfusions were mostly initiated for acute bleeding (61.3% and 61.1%, respectively). The RBC transfusion rate in study centres varied from 2% to 72%. RBC transfusion was inappropriate in 99% (n=150/151) of pre-operative, 23% (n=211/926) of intra-operative and 43% (n=308/716) of post-operative RBC transfusion episodes. Pre-operative haemoglobin, increased blood loss, open surgery and duration of surgery were the main independent predictors of intra-operative RBC transfusion. Low pre-operative haemoglobin concentration was independently associated with post-operative pulmonary complications. CONCLUSIONS: These findings identified areas for improvement in peri-operative transfusion practice and PBM implementation in Turkey.
BACKGROUND:Patients' demographic and epidemiological characteristics, local variations in clinicians' knowledge and experience and types of surgery can influence peri-operative transfusion practices. Sharing data on transfusion practices and recipients may improve patients' care and implementation of Patient Blood Management (PBM). MATERIALS AND METHODS: This was a multicentre, prospective, observational, cross-sectional study that included 61 centres. Clinical and transfusion data of patients undergoing major elective surgery were collected; transfusion predictors and patients' outcomes were analysed. RESULTS: Of 6,121 patients, 1,579 (25.8%) received a peri-operative transfusion. A total of 5,812 blood components were transfused: red blood cells (RBC), fresh-frozen plasma and platelets in 1,425 (23.3%), 762 (12.4%) and 88 (1.4%) cases, respectively). Pre-operative anaemia was identified in 2,019 (33%) patients. Half of the RBC units were used by patients in the age group 45-69 years. Specific procedures with the highest RBC use were coronary artery bypass grafting (16.9% of all units) and hip arthroplasty (14.9%). Low haemoglobin concentration was the most common indication for intra-operative RBC transfusion (57%) and plasma and platelet transfusions were mostly initiated for acute bleeding (61.3% and 61.1%, respectively). The RBC transfusion rate in study centres varied from 2% to 72%. RBC transfusion was inappropriate in 99% (n=150/151) of pre-operative, 23% (n=211/926) of intra-operative and 43% (n=308/716) of post-operative RBC transfusion episodes. Pre-operative haemoglobin, increased blood loss, open surgery and duration of surgery were the main independent predictors of intra-operative RBC transfusion. Low pre-operative haemoglobin concentration was independently associated with post-operative pulmonary complications. CONCLUSIONS: These findings identified areas for improvement in peri-operative transfusion practice and PBM implementation in Turkey.
Authors: Jeffrey L Carson; Michael L Terrin; Helaine Noveck; David W Sanders; Bernard R Chaitman; George G Rhoads; George Nemo; Karen Dragert; Lauren Beaupre; Kevin Hildebrand; William Macaulay; Courtland Lewis; Donald Richard Cook; Gwendolyn Dobbin; Khwaja J Zakriya; Fred S Apple; Rebecca A Horney; Jay Magaziner Journal: N Engl J Med Date: 2011-12-14 Impact factor: 91.245
Authors: Alicia Chen; Amal N Trivedi; Lan Jiang; Michael Vezeridis; William G Henderson; Wen-Chih Wu Journal: Medicine (Baltimore) Date: 2015-08 Impact factor: 1.817