Transfus Med. 1994 Dec;4(4):251-68.
The objective of this study was to assess the use of blood products and artificial colloids in six commonly performed elective surgical procedures in 43 teaching hospitals in 10 European countries. 7,195 patient data were analysed. For each product wide differences were found between hospitals, both in the proportion of patients transfused and the amount of product used for the same patient category. Adjustment for age, gender, preoperative haematocrit and blood loss, left major differences among hospitals in patient red unit transfusion. Hospitals in the Mediterranean area used less albumin and artificial colloids and more autotransfusion than those of central-northern Europe. The reasons for perioperative red cell transfusion were stated in the patient's medical record for 23% of patients. The ratio of preoperative blood request to transfusion was maximal in cholecystectomy, where it exceeded 10. The documentation of blood request and transfusion, and of transfusion complications in medical records, did not fully agree with that in the transfusion service in 49, 53 and 92% of the hospitals, respectively. The wide differences in blood product used for the same patient category were due to a variety of causes of which only some could be explained by the clinical factors taken into account. This suggests that consensus conferences and guidelines have so far had a limited impact on transfusion practice in many clinical units, even in teaching environments.
本研究的目的是评估欧洲10个国家43家教学医院在6种常见择期外科手术中血液制品和人工胶体的使用情况。分析了7195例患者的数据。对于每种产品，各医院之间存在很大差异，无论是输血患者的比例还是同一患者类别所使用的产品量。在对年龄、性别、术前血细胞比容和失血量进行调整后，各医院在患者红细胞输注方面仍存在较大差异。地中海地区的医院比中北欧地区的医院使用白蛋白和人工胶体更少，自体输血更多。23%的患者围手术期红细胞输血原因记录在患者病历中。胆囊切除术中术前备血量与输血量之比最大，超过了10。在49%、53%和92%的医院中，病历中备血和输血以及输血并发症的记录与输血服务中的记录不完全一致。同一患者类别所使用的血液制品存在很大差异，原因多种多样，其中只有一些可以通过所考虑的临床因素来解释。这表明，迄今为止，共识会议和指南对许多临床单位的输血实践影响有限，即使是在教学环境中。
