Fenelon C, Galbraith J G, Kearsley R, Motherway C, Condon F, Lenehan B
Department of Orthopaedic Surgery, University Hospital Limerick, Limerick, Ireland
Department of Anaesthesia, University Hospital Limerick, Limerick, Ireland
Ir Med J. 2018 Apr 19;111(4):730.
Aim Our aim was to quantify blood transfusion rates in lower limb arthroplasty following the introduction of a multimodal enhanced recovery programme (ERP). We then sought to update the maximum surgical blood ordering schedule (MSBOS) and calculate cost savings achieved. Methods A retrospective cohort study was conducted of all patients who required blood transfusion following primary and revision total hip and knee arthroplasty in 2012 and 2015. A multimodal ERP was introduced in 2015. Cost savings were calculated following the introduction of a new MSBOS. Results During the two-year study period 1467 lower limb arthroplasty procedures were performed. The cross-match to transfusion ratio was 3.6:1 in 2012 and 9.9:1 in 2015. The updated MSBOS resulted in a 46% reduction of cross-matched blood and savings of €54,375 per annum. Conclusion Improved perioperative management in lower limb arthroplasty has reduced blood transfusion rates. Updating blood transfusion practice can result in considerable savings in blood, resources and costs.
目的 我们的目的是量化在引入多模式强化康复计划（ERP）后下肢关节置换术中的输血率。然后，我们试图更新最大手术用血预订计划（MSBOS）并计算所实现的成本节约。方法 对2012年和2015年初次及翻修全髋关节和膝关节置换术后需要输血的所有患者进行了一项回顾性队列研究。2015年引入了多模式ERP。在引入新的MSBOS后计算成本节约。结果 在两年的研究期间，共进行了1467例下肢关节置换手术。2012年交叉配血与输血的比例为3.6:1，2015年为9.9:1。更新后的MSBOS使交叉配血的血液减少了46%，每年节省54375欧元。结论 下肢关节置换术中围手术期管理的改善降低了输血率。更新输血实践可在血液、资源和成本方面节省可观的费用。
