cad a22 4500 316949809 20181103043305.0 cr unu---uuuuu 140620s2014 xx s 000 0 eng 10.5167/uzh-96652 doi 10.2450/2014.0306-13 doi (ZORA)oai:www.zora.uzh.ch:96652 610 ddc 24931841 pmid Patient Blood Management in orthopaedic surgery: a four-year follow-up of transfusion requirements and blood loss from 2008 to 2011 at the Balgrist University Hospital in Zurich, Switzerland [Elektronische Daten] [Oliver M Theusinger, Stephanie L Kind, Burkhardt Seifert, Lain Borgeat, Christian Gerber, Donat R Spahn] openAccess eu-repo BACKGROUND: The aim of this study was to investigate the impact of the introduction of a Patient Blood Management (PBM) programme in elective orthopaedic surgery on immediate pre-operative anaemia, red blood cell (RBC) mass loss, and transfusion. MATERIALS AND METHODS: Orthopaedic operations (hip, n=3,062; knee, n=2,953; and spine, n=2,856) performed between 2008 and 2011 were analysed. Period 1 (2008), was before the introduction of the PBM programme and period 2 (2009 to 2011) the time after its introduction. Immediate pre-operative anaemia, RBC mass loss, and transfusion rates in the two periods were compared. RESULTS: In hip surgery, the percentage of patients with immediate pre-operative anaemia decreased from 17.6% to 12.9% (p<0.001) and RBC mass loss was unchanged, being 626±434 vs 635±450 mL (p=0.974). Transfusion rate was significantly reduced from 21.8% to 15.7% (p<0.001). The number of RBC units transfused remained unchanged (p=0.761). In knee surgery the prevalence of immediate pre-operative anaemia decreased from 15.5% to 7.8% (p<0.001) and RBC mass loss reduced from 573±355 to 476±365 mL (p<0.001). The transfusion rate dropped from 19.3% to 4.9% (p<0.001). RBC transfusions decreased from 0.53±1.27 to 0.16±0.90 units (p<0.001). In spine surgery the prevalence of immediate pre-operative anaemia remained unchanged (p=0.113), RBC mass loss dropped from 551±421 to 404±337 mL (p<0.001), the transfusion rate was reduced from 18.6 to 8.6% (p<0.001) and RBC transfusions decreased from 0.66±1.80 to 0.22±0.89 units (p=0.008). DISCUSSION: Detection and treatment of pre-operative anaemia, meticulous surgical technique, optimal surgical blood-saving techniques, and standardised transfusion triggers in the context of PBM programme resulted in a lower incidence of immediate pre-operative anaemia, reduction in RBC mass loss, and a lower transfusion rate. Balgrist University Hospital, Swiss Spinal Cord Injury Center zora Epidemiology, Biostatistics and Prevention Institute (EBPI) zora Institute of Anesthesiology zora Theusinger Oliver M. joint author Kind Stephanie L. joint author Seifert Burkhardt joint author Borgeat Lain joint author Gerber Christian joint author Spahn Donat R. joint author Blood Transfusion 12(2):195-203 https://www.zora.uzh.ch/id/eprint/96652/1/Theusinger_OM_Blood_Transfus_2014_12_195.pdf text/html WWW-Backlink auf das Repository 1 Journal Article PeerReviewed zora ZORA 856 40 https://www.zora.uzh.ch/id/eprint/96652/1/Theusinger_OM_Blood_Transfus_2014_12_195.pdf text/html WWW-Backlink auf das Repository ZORA 700 1- Theusinger Oliver M. joint author ZORA 700 1- Kind Stephanie L. joint author ZORA 700 1- Seifert Burkhardt joint author ZORA 700 1- Borgeat Lain joint author ZORA 700 1- Gerber Christian joint author ZORA 700 1- Spahn Donat R. joint author ZORA 773 0- Blood Transfusion 12(2):195-203 BK010053 XK010053 XK010000 ZORA ZORA ZORA Journal Article openAccess