Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Seoul, South Korea.
Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea.
Transfus Med. 2021 Feb;31(1):55-62. doi: 10.1111/tme.12754. Epub 2020 Dec 27.
Patient blood management (PBM) programmes minimise red blood cell (RBC) transfusion and improve patient outcomes worldwide. This study evaluated the effect of a multidisciplinary, collaborative PBM programme on the appropriateness of RBC transfusion in medical and surgical departments at a hospital level.
METHODS/MATERIALS: In 2018, the revised PBM programme was launched at the Korea University Anam Hospital, a tertiary hospital with 1048 hospital beds and the first Asian institution where a new computer PBM programme was implemented. Monthly RBC usage and adequacy were analysed from January 2018 to December 2019. The trend of adequacy over time was assessed.
A total of 2 201 021 patients were hospitalised and visited an outpatient clinic. The number of RBC units transfused per 10 000 patients decreased from 139.8 for 2018 to 137.3 for 2019. The proportion of patients with Hb <7 g/dL receiving RBC transfusion increased significantly: 29.1%, 34.5%, 40.4% and 40.6% for periods 1, 2, 3 and 4, respectively (p < 0.001). The appropriateness of RBC transfusion significantly increased for medical (35.2%, 41.5%, 49.6% and 74.3% for periods 1, 2, 3 and 4, respectively [p < 0.001]) and surgical (37.8%, 33.3%, 45.5% and 71.1% for periods 1, 2, 3 and 4, respectively [p < 0.001]) departments.
Implementation of a PBM programme through a multidisciplinary clinical community approach increased the appropriateness of RBC transfusion in medical and surgical departments. Therefore, expanding publicity and PBM education to health care providers is important to maintain the appropriateness of blood transfusion.
患者血液管理（PBM）计划可最大限度地减少红细胞（RBC）输血，并改善全球患者的结局。本研究评估了多学科协作的 PBM 计划对医院级别的内科和外科部门 RBC 输血的适当性的影响。
方法/材料：2018 年，韩国大学安岩医院（一家拥有 1048 张病床的三级医院，是首家实施新型计算机 PBM 计划的亚洲机构）推出了修订后的 PBM 计划。从 2018 年 1 月至 2019 年 12 月，每月分析 RBC 的使用量和充足性。评估了随时间推移的充足性趋势。
共有 2201021 名患者住院和就诊于门诊。每 10000 名患者的 RBC 单位输注量从 2018 年的 139.8 降至 2019 年的 137.3。Hb<7 g/dL 的患者接受 RBC 输血的比例显著增加：第 1、2、3 和 4 期分别为 29.1%、34.5%、40.4%和 40.6%（p<0.001）。内科（第 1、2、3 和 4 期分别为 35.2%、41.5%、49.6%和 74.3%[p<0.001]）和外科（第 1、2、3 和 4 期分别为 37.8%、33.3%、45.5%和 71.1%[p<0.001]）部门的 RBC 输血的适当性显著增加。
通过多学科临床社区方法实施 PBM 计划增加了内科和外科部门 RBC 输血的适当性。因此，向医疗保健提供者扩大宣传和 PBM 教育对于维持输血的适当性很重要。
