Albinarrate A, López-Picado A, Oiartzabal I, López-Ariznabarreta C, Molano J, Barrachina B
Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Araba, Vitoria-Gasteiz, Álava, España.
Unidad de Investigación de Araba, Hospital Universitario Araba, Vitoria-Gasteiz, Álava, España.
Rev Esp Anestesiol Reanim. 2015 Oct;62(8):443-9. doi: 10.1016/j.redar.2014.09.004. Epub 2014 Oct 12.
To assess the impact of implementing a Patient Blood management program (PBM) on transfusion rates, hospital stay, and complications for total hip arthroplasty (THA) and total knee arthroplasty (TKA).
A retrospective, observational study was conducted in Araba University Hospital from 2006 to 2011. All THA and TKA were included. The percentage of patients transfused with allogeneic blood was the primary endpoint. The mean of transfused blood bags, overall transfusion, complications (both overall and specific), patient age and sex, pre-operative and discharge hemoglobin, and hospital stay were recorded.
A total of 825 THA and 875 TKA were included. Both THA (47.6% in 2006 and 30.6% in 2011; P=.013) and TKA (33.6% in 2006 and 16.2% in 2011; P<.001) showed a significant decrease of allogeneic transfusion. The overall transfusion rate was also reduced in THA (65.7% in 2006 and 39.5% in 2011; P<.001) and TKA (38.3% in 2006 and 17.2% in 2011; P<.001). Hospital stay was reduced in both types of surgeries (P<.038 in THA and P<.0001 in TKA). In 2006 it was 9.2±2.9 days for THA and 11.1±4.7 days for TKA, whereas in 2011 it was 8.7±4.2 and 9.5±3.4 days for THA and TKA, respectively.
Our patient blood management has decreased the percentage of patients that need both allogeneic and autologous transfusion in a statistically significant way. Although the mean hospital stay decreased, the impact of the PBM cannot be established.
评估实施患者血液管理计划（PBM）对全髋关节置换术（THA）和全膝关节置换术（TKA）的输血率、住院时间及并发症的影响。
2006年至2011年在阿拉瓦大学医院进行了一项回顾性观察研究。纳入所有THA和TKA病例。输注异体血的患者百分比为主要终点。记录输注血袋的平均数、总体输血情况、并发症（总体及特定并发症）、患者年龄和性别、术前及出院时血红蛋白水平以及住院时间。
共纳入825例THA和875例TKA。THA（2006年为47.6%，2011年为30.6%；P = 0.013）和TKA（2006年为33.6%，2011年为16.2%；P < 0.001）的异体输血率均显著下降。THA（2006年为65.7%，2011年为39.5%；P < 0.001）和TKA（2006年为38.3%，2011年为17.2%；P < 0.001）的总体输血率也有所降低。两种手术的住院时间均缩短（THA中P < 0.038，TKA中P < 0.0001）。2006年THA的住院时间为9.2±2.9天，TKA为11.1±4.7天，而2011年THA为8.7±4.2天，TKA为9.5±3.4天。
我们的患者血液管理在统计学上显著降低了需要异体输血和自体输血的患者百分比。虽然平均住院时间缩短，但PBM的影响尚不能确定。
