一项意大利全国范围的血液临床使用调查。
A nationwide survey of clinical use of blood in Italy.
机构信息
Italian Society of Transfusion Medicine and Immunohaematology, Rome, Italy.
Immunohaematology and Transfusion Medicine Centre, Provincial Health Authority n. 7, Ragusa - "R. Guzzardi" Hospital, Vittoria, Italy.
出版信息
Blood Transfus. 2021 Sep;19(5):384-395. doi: 10.2450/2021.0083-21. Epub 2021 Aug 5.
BACKGROUND
In Italy, as in many developed countries, a decline in blood component (BC) consumption, especially red blood cells (RBC), has been described, but not studied at a national level. We, therefore, designed a nationwide survey to determine the main features of BC recipients and obtain a picture of the clinical use of BC for the first time in Italy, in order to understand BC demands better and identify specific fields in which to apply Patient Blood Management (PBM).
MATERIAL AND METHODS
A nationwide survey of all Italian Blood Establishments working as Hospital Blood Banks (HBB) was performed. Data were collected through an online report form recording information on the number and geographic area of the responding HBB, year of birth and sex of the BC recipients, and clinical indications for every unit of RBC, platelets and plasma transfused in a 24-hour period.
RESULTS
On the survey date, 153/237 (64.5%) of the HBB returned 4,356 forms, reporting 7,523 transfusions. The median and mean ages of the recipients were 73 (range, 0-106) and 67.5 years, respectively; 33.0% were >80 years old and 64.9% >65 years old, with no relevant differences between males and females. Overall, 6,309 RBC units were transfused to 3,850 recipients, 66.7% of them for a medical indication and 32.4% for a surgical indication. The commonest medical indication was acquired, non-cancer-related anaemia and more than 30% of the transfusions occurred in the Emergency Department. Five hundred and sixty platelet transfusions were given to 520 recipients, 62.7% of them for prophylaxis and 28.6% for bleeding before or during an invasive procedure or surgery or for thrombocytopenia. One hundred and ninety-four patients received 654 units of plasma, 71.1% of which were for therapeutic purposes in bleeding patients.
DISCUSSION
We collected a picture of blood transfusion epidemiology in Italy. The data suggest that future PBM plans should be focused on medical anaemia especially in the setting of Emergency Departments.
背景
在意大利，与许多发达国家一样，血液成分（BC）的消耗，尤其是红细胞（RBC）的消耗有所下降，但尚未在全国范围内进行研究。因此，我们设计了一项全国性调查，以确定 BC 接受者的主要特征，并首次了解意大利 BC 的临床应用情况，以便更好地了解 BC 的需求，并确定应用患者血液管理（PBM）的具体领域。
材料和方法
对所有作为医院血库（HBB）运作的意大利血液中心进行了全国性调查。通过在线报告表格收集数据，记录了应答 HBB 的数量和地理区域、BC 接受者的出生年份和性别，以及在 24 小时内输注的每单位 RBC、血小板和血浆的临床指征。
结果
在调查日，153/237（64.5%）的 HBB 回复了 4356 份表格，报告了 7523 次输血。接受者的中位数和平均值年龄分别为 73（范围，0-106）和 67.5 岁；33.0%的年龄大于 80 岁，64.9%的年龄大于 65 岁，男性和女性之间没有明显差异。总体而言，6309 单位 RBC 输注给 3850 名接受者，其中 66.7%是医疗指征，32.4%是手术指征。最常见的医疗指征是获得性、非癌症相关贫血，超过 30%的输血发生在急诊科。560 次血小板输注给 520 名接受者，其中 62.7%用于预防，28.6%用于侵入性操作或手术前或期间的出血或血小板减少症。194 名患者接受了 654 单位的血浆，其中 71.1%用于出血患者的治疗。
讨论
我们收集了意大利输血流行病学的图片。数据表明，未来的 PBM 计划应侧重于医疗性贫血，特别是在急诊科。
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