Audet A M, Andrzejewski C, Popovsky M
Massachusetts Peer Review Organization, USA.
Eval Health Prof. 1998 Dec;21(4):487-501. doi: 10.1177/016327879802100407.
Orthopedic surgery is a common procedure among the elderly, and patients are at risk of receiving unnecessary blood transfusions. The goals of this project were to analyze current transfusion practices, identify opportunities for improvement, implement hospital-based quality improvement programs, and measure their impact on transfusion practices. Our aims were to decrease unnecessary transfusions and overall exposure to blood products. Data were abstracted from medical records, at baseline and postintervention. The results demonstrated significant improvements: a 55% decrease in avoidable transfusion events (from 42% to 19%, p < .001) and a decrease in the pre-transfusion hematocrit from a baseline of 29% to 26.9% in the postintervention period (p < .01). The percentage of single unit transfusion events increased from 71.9% to 77.2% (p = .05). These results suggest that the interventions had a significant impact on the use of blood. In the long term, these results should translate into cost savings and improved patient outcomes.
骨科手术在老年人中是一种常见的手术，患者有接受不必要输血的风险。该项目的目标是分析当前的输血实践，确定改进机会，实施基于医院的质量改进计划，并衡量其对输血实践的影响。我们的目标是减少不必要的输血以及减少血液制品的总体暴露。在基线和干预后从医疗记录中提取数据。结果显示有显著改善：可避免的输血事件减少了55%（从42%降至19%，p < .001），干预后输血前血细胞比容从基线的29%降至26.9%（p < .01）。单单位输血事件的百分比从71.9%增加到77.2%（p = .05）。这些结果表明干预措施对血液使用有显著影响。从长远来看，这些结果应转化为成本节约和改善患者预后。
