Alejandro Godoy1, Jaqueline Gonzalez2, Ana Florencia Becerra3, Mariano Finola4, Facundo Faule5, Carlos Estrada6, Yamile Neder7, Ricardo Albertini8. 1. Hospital Privado Universitario de Cordoba. ale_nano@hotmail.com. 2. Hospital Privado Universitario de Córdoba . jacquigmg89@gmail.com. 3. Hospital Privado Universitario de Córdoba . flor_med68@hotmail.com. 4. Hospital Privado Universitario de Córdoba . mariano.f@hotmail.com. 5. Hospital Privado Universitario de Córdoba . facu_faule@hotmail.com. 6. Hospital Privado Universitario de Córdoba . carlos.estrada@hotmail.com. 7. Hospital Privado Universitario de Córdoba . yamile.neder@hotmail.com. 8. Hospital Privado Universitario de Córdoba . ricartualbertini@hotmail.com.
Abstract
Introduction: Patient Blood Management (PBM) programs improve patient care and reduce health costs. It includes detection of presurgical anemia, reduction of blood loss and improvement of patient-specific anemic reserve. The aim of this study is to assess the effect of a PBM program on transfusion rate, length of stay (LOS) and adverse events. Methods: We developed a retrospective observational study. We included patients who underwent total hip (THR) o knee replacement (TKR). Our PBM involved preoperative assessment, administration of 2 doses of tranexamic acid, application of restrictive transfusion criteria and use of IV iron. We compared results between the group of patients before and the one after the PBM implementation. Results: We included 179 patients (80 TKR and 99 THR) who underwent surgery before PBM implementation from January to December 2014 (Group A), and 187 patients (103 TKR and 84 THR) who underwent arthroplasty after PBM application from January to November 2016 (Group B). In Group A, hemoglobin drop was larger than in Group B, for TKR (5.1±1.2 vs. 4.2±1.2 g/dl; p<0,05) and for THR (4.7±1.3 vs. 3.8±1.3 g/dl; p<0,05). In group A, more patients were transfused (31.8% vs. 2.7%; p<0.001). LOS was longer for patients in group A, in both surgeries (for TKA, 3.98±1.4days vs. 2.99±0.95 days; p<0.0001; for THA 3.68±1.06days vs. 2.88±0.75days; p<0.0001). No significant differences were found regarding adverse events. Conclusion: Our PBM program saved transfusions after primary TKR and THR and lowered LOS, without risking patients to higher number of complications or death. Universidad Nacional de Córdoba
Introduction: Patient Blood Management (PBM) programs improve patient care and reduce health costs. It includes detection of presurgical anemia, reduction of blood loss and improvement of patient-specific anemic reserve. The aim of this study is to assess the effect of a PBM program on transfusion rate, length of stay (LOS) and adverse events. Methods: We developed a retrospective observational study. We included patients who underwent total hip (THR) o knee replacement (TKR). Our PBM involved preoperative assessment, administration of 2 doses of tranexamic acid, application of restrictive transfusion criteria and use of IV iron. We compared results between the group of patients before and the one after the PBM implementation. Results: We included 179 patients (80 TKR and 99 THR) who underwent surgery before PBM implementation from January to December 2014 (Group A), and 187 patients (103 TKR and 84 THR) who underwent arthroplasty after PBM application from January to November 2016 (Group B). In Group A, hemoglobin drop was larger than in Group B, for TKR (5.1±1.2 vs. 4.2±1.2 g/dl; p<0,05) and for THR (4.7±1.3 vs. 3.8±1.3 g/dl; p<0,05). In group A, more patients were transfused (31.8% vs. 2.7%; p<0.001). LOS was longer for patients in group A, in both surgeries (for TKA, 3.98±1.4days vs. 2.99±0.95 days; p<0.0001; for THA 3.68±1.06days vs. 2.88±0.75days; p<0.0001). No significant differences were found regarding adverse events. Conclusion: Our PBM program saved transfusions after primary TKR and THR and lowered LOS, without risking patients to higher number of complications or death. Universidad Nacional de Córdoba
Authors: Navendu Goyal; Darren B Chen; Ian A Harris; Neville J Rowden; George Kirsh; Samuel J MacDessi Journal: J Arthroplasty Date: 2016-07-15 Impact factor: 4.757
Authors: Yale A Fillingham; Dipak B Ramkumar; David S Jevsevar; Adolph J Yates; Peter Shores; Kyle Mullen; Stefano A Bini; Henry D Clarke; Emil Schemitsch; Rebecca L Johnson; Stavros G Memtsoudis; Siraj A Sayeed; Alexander P Sah; Craig J Della Valle Journal: J Arthroplasty Date: 2018-06-27 Impact factor: 4.757
Authors: Jedediah H May; Geoffrey R Rieser; Chad G Williams; Ronald J Markert; Ryan D Bauman; Matthew W Lawless Journal: J Arthroplasty Date: 2016-04-30 Impact factor: 4.757