Dernedde U, Dernedde R, Shepstone L, Barrett A
Norfolk and Norwich University Hospital NHS Trust, Norwich NR4 7UZ, UK.
Clin Oncol (R Coll Radiol). 2007 May;19(4):223-7. doi: 10.1016/j.clon.2006.11.011. Epub 2006 Dec 11.
To assess recent developments in the use of transfusions.
Data from hospital-based sources were condensed in a single spread sheet covering 1611 transfusions of a total of 881 patients together with data on 25,264 treatment sessions in 6137 patients within a time period between 1 August 2001 and 31 July 2004.
Our audit showed an increase in transfusions of 25% in 3 years. This was accompanied by an increased threshold for transfusions, as shown by a significant rise in mean haemoglobin trigger levels from 8.53 to 8.86 g/dl (P<0.001) as well as an increase in treatment sessions and patient numbers - especially for chemotherapy or combinations of chemotherapy and radiotherapy. The highest transfusion rates and also the greatest increments occurred in patients with carcinoma of the ovary, lung and pancreas. Within these groups, treatment regimens as well as treatment lines were additional predictive factors.
This audit gives a detailed view on rising trends in transfusion requirements and, in light of anticipated restrictions on resources, it identifies high-risk areas, where the use of alternatives, such as erythropoietin, could be considered.
评估输血应用的近期发展情况。
来自医院的数据汇总在一个电子表格中,涵盖了881例患者的1611次输血情况,以及2001年8月1日至2004年7月31日期间6137例患者的25264个治疗疗程的数据。
我们的审核显示,3年内输血次数增加了25%。这伴随着输血阈值的提高,平均血红蛋白触发水平从8.53克/分升降至8.86克/分升,显著上升(P<0.001),同时治疗疗程和患者数量也有所增加,尤其是化疗或化疗与放疗联合治疗的情况。卵巢癌、肺癌和胰腺癌患者的输血率最高,增幅也最大。在这些组中,治疗方案以及治疗线是额外的预测因素。
本次审核详细呈现了输血需求的上升趋势,鉴于预期的资源限制,它确定了高风险领域,在这些领域可以考虑使用促红细胞生成素等替代方法。