Anwar Sibtain, Green Laura, Cooper Jackie, Curtis Miles, Roberts Neil, Sanders Julie, Scully Marie, Stables Victoria, O'Brien Ben
Barts Health NHS Trust, London, UK, Barts and the London School of Medicine and Dentistry, London, UK, William Harvey Research Institute, London, UK and Outcomes Research Consortium, Cleveland, USA.
Barts Health NHS Trust, London, UK, Queen Mary University of London, London, UK and NHS Blood and Transplant, London, UK.
Future Healthc J. 2020 Feb;7(1):72-77. doi: 10.7861/fhj.2019-0014.
In 2015, three London cardiac centres, with different transfusion infrastructure support, merged to form the Barts Heart Centre. We describe the impact on transfusion rate, blood usage and interoperator variation.
Data was collected on all adult patients undergoing cardiac surgery during 2014 as well as 2016, using the National Institute Cardiovascular Outcomes Research (NICOR) data set.
Over the two time periods, a total of 3,647 cardiac procedures were performed (1,930 in 2014 and 1,717 in 2016). There were no significant differences in type of surgery or patient comorbidity between the two epochs of time. Overall, red blood cell transfusion at 24 hours and until hospital discharge reduced significantly in 2016 (odds ratio 0.77; 95% confidence interval 0.68-0.89; p=0.0002). Interoperator variability (adjusted for comorbidities) reduced after merger from standard deviation 0.394 (standard error (SE) 0.096) to 0.269 (SE 0.082), p=0.001.
Clinical and organisational factors can improve transfusion service.
2015年，三个拥有不同输血基础设施支持的伦敦心脏中心合并，组建了巴茨心脏中心。我们描述了这一合并对输血率、血液使用情况以及操作者间差异的影响。
利用国家心血管结局研究所（NICOR）数据集，收集了2014年和2016年期间所有接受心脏手术的成年患者的数据。
在这两个时间段内，共进行了3647例心脏手术（2014年为1930例，2016年为1717例）。两个时期的手术类型或患者合并症情况均无显著差异。总体而言，2016年术后24小时及直至出院时的红细胞输注量显著减少（优势比0.77；95%置信区间0.68 - 0.89；p = 0.0002）。合并后，经合并症校正的操作者间变异性从标准差0.394（标准误（SE）0.096）降至0.269（SE 0.082），p = 0.001。
临床和组织因素可改善输血服务。
