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英国急性护理环境中贫血管理评估:协作方法的价值。

An assessment of the management of anaemia in acute care settings in the United Kingdom: The value of a collaborative approach.

机构信息

Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Oxford University Graduate Academic School, Oxford, UK.

出版信息

Transfus Med. 2021 Oct;31(5):322-327. doi: 10.1111/tme.12789. Epub 2021 May 30.

Abstract

OBJECTIVES

Patients presenting to acute care settings with anaemia are at risk of inadequate investigation and inappropriate blood transfusion. In collaboration with Haematology Specialty Trainee Audit and Research (HaemSTAR), this study set out to assess current red blood cell (RBC) transfusion practice and anaemia management in acute care settings across the United Kingdom.

METHODS AND RESULTS

Fifteen different hospitals participated in the study over a period of a month beginning 01 January 2020. Eight-hundred and twenty-eight eligible patients presenting to acute care settings with anaemia received RBC transfusions during this period. Of these, 159 (19.2%) received inappropriate transfusions according to National Institute for Health and Care Excellence guidelines, and 257 (31%) could have been treated with alternatives to transfusion. One-hundred and fifty-four (18.6%) did not have a cause for their anaemia identified by the time they were discharged from hospital, and in over 50% of these cases that was because of inadequate investigation with blood tests, specialist investigation or referral, or both.

CONCLUSION

This study found that the appropriateness of transfusion and investigation of anaemia in acute care settings warrant improvement and also demonstrates the value of HaemSTAR in facilitating time-efficient collection of high-quality data.

摘要

目的

在急性护理环境中出现贫血的患者存在调查不足和输血不当的风险。与血液科专科培训生审计和研究(HaemSTAR)合作,本研究旨在评估英国急性护理环境中当前的红细胞(RBC)输血实践和贫血管理情况。

方法和结果

在 2020 年 1 月 1 日开始的一个月期间,有 15 家不同的医院参与了这项研究。在此期间,828 名贫血患者在急性护理环境中接受了 RBC 输血。其中,根据国家卫生与保健卓越研究所(National Institute for Health and Care Excellence)的指南,有 159 例(19.2%)输血不当,257 例(31%)可以选择输血以外的治疗方法。有 154 例(18.6%)在出院时仍未确定贫血的原因,在这些病例中,超过 50%的原因是由于血液检查、专科检查或转诊,或两者均不足。

结论

本研究发现,急性护理环境中输血和贫血调查的适宜性需要改进,同时也展示了 HaemSTAR 在促进高效收集高质量数据方面的价值。

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