Perioperative protocol to reduce blood transfusions in total knee o hip replacement patients

Introduction Patient Blood Management (PBM) programs improve patient care and reduce health costs. It includes detection of presurgical anemia, reduction of blood loss and improvement of patient-specific anemic reserve. The aim of this study is to assess the effect of a PBM program on transfusion ra...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Godoy, Alejandro, Gonzalez, Jaqueline, Becerra, Ana Florencia, Finola , Mariano, Faule, Facundo, Estrada , Carlos, Neder, Yamile, Albertini , Ricardo
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021
Materias:
arthroplasty replacement
blood transfusion
anemia
Tranexamic Acid
artroplastia de reemplazo
transfusión sanguínea
Ácido Tranexámico
artroplastia de substituição
transfusão de sangue;
Ácido Tranexâmico
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/30134
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
id I10-R327-article-30134
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Español
format Artículo revista
topic arthroplasty replacement
blood transfusion
anemia
Tranexamic Acid
artroplastia de reemplazo
transfusión sanguínea
anemia
Ácido Tranexámico
artroplastia de substituição
transfusão de sangue;
anemia
Ácido Tranexâmico
spellingShingle arthroplasty replacement
blood transfusion
anemia
Tranexamic Acid
artroplastia de reemplazo
transfusión sanguínea
anemia
Ácido Tranexámico
artroplastia de substituição
transfusão de sangue;
anemia
Ácido Tranexâmico
Godoy, Alejandro
Gonzalez, Jaqueline
Becerra, Ana Florencia
Finola , Mariano
Faule, Facundo
Estrada , Carlos
Neder, Yamile
Albertini , Ricardo
Perioperative protocol to reduce blood transfusions in total knee o hip replacement patients
topic_facet arthroplasty replacement
blood transfusion
anemia
Tranexamic Acid
artroplastia de reemplazo
transfusión sanguínea
anemia
Ácido Tranexámico
artroplastia de substituição
transfusão de sangue;
anemia
Ácido Tranexâmico
author Godoy, Alejandro
Gonzalez, Jaqueline
Becerra, Ana Florencia
Finola , Mariano
Faule, Facundo
Estrada , Carlos
Neder, Yamile
Albertini , Ricardo
author_facet Godoy, Alejandro
Gonzalez, Jaqueline
Becerra, Ana Florencia
Finola , Mariano
Faule, Facundo
Estrada , Carlos
Neder, Yamile
Albertini , Ricardo
author_sort Godoy, Alejandro
title Perioperative protocol to reduce blood transfusions in total knee o hip replacement patients
title_short Perioperative protocol to reduce blood transfusions in total knee o hip replacement patients
title_full Perioperative protocol to reduce blood transfusions in total knee o hip replacement patients
title_fullStr Perioperative protocol to reduce blood transfusions in total knee o hip replacement patients
title_full_unstemmed Perioperative protocol to reduce blood transfusions in total knee o hip replacement patients
title_sort perioperative protocol to reduce blood transfusions in total knee o hip replacement patients
description Introduction Patient Blood Management (PBM) programs improve patient care and reduce health costs. It includes detection of presurgical anemia, reduction of blood loss and improvement of patient-specific anemic reserve. The aim of this study is to assess the effect of a PBM program on transfusion rate, length of stay (LOS) and adverse events.    Methods We developed a retrospective observational study. We included patients who underwent total hip (THR) o knee replacement (TKR). Our PBM involved preoperative assessment, administration of 2 doses of tranexamic acid, application of restrictive transfusion criteria and use of IV iron. We compared results between the group of patients before and the one after the PBM implementation.   Results We included 179 patients (80 TKR and 99 THR) who underwent surgery before PBM implementation from January to December 2014 (Group A), and 187 patients (103 TKR and 84 THR) who underwent arthroplasty after PBM application from January to November 2016 (Group B). In Group A, hemoglobin drop was larger than in Group B, for TKR (5.1±1.2 vs. 4.2±1.2 g/dl; p<0,05) and for THR (4.7±1.3 vs. 3.8±1.3 g/dl; p<0,05). In group A, more patients were transfused (31.8% vs. 2.7%; p<0.001). LOS was longer for patients in group A, in both surgeries (for TKA, 3.98±1.4days vs. 2.99±0.95 days; p<0.0001; for THA 3.68±1.06days vs. 2.88±0.75days; p<0.0001). No significant differences were found regarding adverse events.   Conclusion Our PBM program saved transfusions after primary TKR and THR and lowered LOS, without risking patients to higher number of complications or death.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2021
url https://revistas.unc.edu.ar/index.php/med/article/view/30134
work_keys_str_mv AT godoyalejandro perioperativeprotocoltoreducebloodtransfusionsintotalkneeohipreplacementpatients
AT gonzalezjaqueline perioperativeprotocoltoreducebloodtransfusionsintotalkneeohipreplacementpatients
AT becerraanaflorencia perioperativeprotocoltoreducebloodtransfusionsintotalkneeohipreplacementpatients
AT finolamariano perioperativeprotocoltoreducebloodtransfusionsintotalkneeohipreplacementpatients
AT faulefacundo perioperativeprotocoltoreducebloodtransfusionsintotalkneeohipreplacementpatients
AT estradacarlos perioperativeprotocoltoreducebloodtransfusionsintotalkneeohipreplacementpatients
AT nederyamile perioperativeprotocoltoreducebloodtransfusionsintotalkneeohipreplacementpatients
AT albertiniricardo perioperativeprotocoltoreducebloodtransfusionsintotalkneeohipreplacementpatients
AT godoyalejandro implementaciondeprotocoloperioperatorioparadisminuirtasadetransfusionesenpacientessometidosareemplazototaldecaderaorodillaprimarios
AT gonzalezjaqueline implementaciondeprotocoloperioperatorioparadisminuirtasadetransfusionesenpacientessometidosareemplazototaldecaderaorodillaprimarios
AT becerraanaflorencia implementaciondeprotocoloperioperatorioparadisminuirtasadetransfusionesenpacientessometidosareemplazototaldecaderaorodillaprimarios
AT finolamariano implementaciondeprotocoloperioperatorioparadisminuirtasadetransfusionesenpacientessometidosareemplazototaldecaderaorodillaprimarios
AT faulefacundo implementaciondeprotocoloperioperatorioparadisminuirtasadetransfusionesenpacientessometidosareemplazototaldecaderaorodillaprimarios
AT estradacarlos implementaciondeprotocoloperioperatorioparadisminuirtasadetransfusionesenpacientessometidosareemplazototaldecaderaorodillaprimarios
AT nederyamile implementaciondeprotocoloperioperatorioparadisminuirtasadetransfusionesenpacientessometidosareemplazototaldecaderaorodillaprimarios
AT albertiniricardo implementaciondeprotocoloperioperatorioparadisminuirtasadetransfusionesenpacientessometidosareemplazototaldecaderaorodillaprimarios
AT godoyalejandro implementacaodeumprotocoloperioperatorioparareduzirataxadetransfusoesempacientessubmetidosaprotesetotalprimariadequadriloujoelho
AT gonzalezjaqueline implementacaodeumprotocoloperioperatorioparareduzirataxadetransfusoesempacientessubmetidosaprotesetotalprimariadequadriloujoelho
AT becerraanaflorencia implementacaodeumprotocoloperioperatorioparareduzirataxadetransfusoesempacientessubmetidosaprotesetotalprimariadequadriloujoelho
AT finolamariano implementacaodeumprotocoloperioperatorioparareduzirataxadetransfusoesempacientessubmetidosaprotesetotalprimariadequadriloujoelho
AT faulefacundo implementacaodeumprotocoloperioperatorioparareduzirataxadetransfusoesempacientessubmetidosaprotesetotalprimariadequadriloujoelho
AT estradacarlos implementacaodeumprotocoloperioperatorioparareduzirataxadetransfusoesempacientessubmetidosaprotesetotalprimariadequadriloujoelho
AT nederyamile implementacaodeumprotocoloperioperatorioparareduzirataxadetransfusoesempacientessubmetidosaprotesetotalprimariadequadriloujoelho
AT albertiniricardo implementacaodeumprotocoloperioperatorioparareduzirataxadetransfusoesempacientessubmetidosaprotesetotalprimariadequadriloujoelho
first_indexed 2024-09-03T21:02:04Z
last_indexed 2024-09-03T21:02:04Z
_version_ 1809210224995729408
spelling I10-R327-article-301342021-12-29T20:15:49Z Perioperative protocol to reduce blood transfusions in total knee o hip replacement patients Implementación de protocolo perioperatorio para disminuir tasa de transfusiones en pacientes sometidos a reemplazo total de cadera o rodilla primarios Implementação de um protocolo perioperatório para reduzir a taxa de transfusões em pacientes submetidos a prótese total primária de quadril ou joelho Godoy, Alejandro Gonzalez, Jaqueline Becerra, Ana Florencia Finola , Mariano Faule, Facundo Estrada , Carlos Neder, Yamile Albertini , Ricardo arthroplasty replacement blood transfusion anemia Tranexamic Acid artroplastia de reemplazo transfusión sanguínea anemia Ácido Tranexámico artroplastia de substituição transfusão de sangue; anemia Ácido Tranexâmico Introduction Patient Blood Management (PBM) programs improve patient care and reduce health costs. It includes detection of presurgical anemia, reduction of blood loss and improvement of patient-specific anemic reserve. The aim of this study is to assess the effect of a PBM program on transfusion rate, length of stay (LOS) and adverse events.    Methods We developed a retrospective observational study. We included patients who underwent total hip (THR) o knee replacement (TKR). Our PBM involved preoperative assessment, administration of 2 doses of tranexamic acid, application of restrictive transfusion criteria and use of IV iron. We compared results between the group of patients before and the one after the PBM implementation.   Results We included 179 patients (80 TKR and 99 THR) who underwent surgery before PBM implementation from January to December 2014 (Group A), and 187 patients (103 TKR and 84 THR) who underwent arthroplasty after PBM application from January to November 2016 (Group B). In Group A, hemoglobin drop was larger than in Group B, for TKR (5.1±1.2 vs. 4.2±1.2 g/dl; p<0,05) and for THR (4.7±1.3 vs. 3.8±1.3 g/dl; p<0,05). In group A, more patients were transfused (31.8% vs. 2.7%; p<0.001). LOS was longer for patients in group A, in both surgeries (for TKA, 3.98±1.4days vs. 2.99±0.95 days; p<0.0001; for THA 3.68±1.06days vs. 2.88±0.75days; p<0.0001). No significant differences were found regarding adverse events.   Conclusion Our PBM program saved transfusions after primary TKR and THR and lowered LOS, without risking patients to higher number of complications or death. Introducción Los protocolos de manejo de anemia perioperatoria mejoran el cuidado del paciente y disminuyen los costos en salud. El objetivo de este estudio fue identificar el efecto de dicho programa en pacientes sometidos a reemplazo total de cadera (RTC) o rodilla (RTR), en la tasa de transfusiones, tiempo de estadía hospitalaria y eventos adversos. Métodos Se realizó un estudio observacional retrospectivo, incluyendo pacientes sometidos a RTC o RTR primarios. El programa abarcó la valoración preoperatoria, el uso de 2 dosis de ácido tranexámico, la aplicación de transfusiones restringidas, y el uso de hierro suplementario. Se compararon los resultados entre pacientes pre y post implementación del protocolo. Resultados Se incluyeron 179 pacientes (80 RTR y 99 RTC) pre protocolo entre enero y diciembre 2014 (grupo A) y 187 casos (103 RTR y 84 RTC) post protocolo entre enero y noviembre 2016 (grupo B). En el grupo A, la caida de hemoglobina fue mayor que en el grupo B en RTR (5,1±1,2 vs. 4,2±1,2 g/dl; p<0,05) y en RTC (4,7±1.3 vs. 3,8±1.3 g/dl; p<0,05). Hubo mayor requerimiento transfusional en el grupo A (31,8% vs. 2,7%; p<0,001). El tiempo de estadía hospitalaria (TEH) fue mayor en el grupo A para ambas cirugías (en RTR 3,98±1,4días vs. 2,99±0,95 días; p<0,0001; en RTC 3,68±1,06días vs. 2,88±0,75días; p<0,0001). No se encontraron diferencias significativas respecto a eventos adversos. Conclusión  En ambas artroplastias, nuestro programa disminuyó la cantidad de transfusiones, la caída de hemoglobina y la estadía hospitalaria, sin aumentar el número de complicaciones. Introdução Os protocolos de gerenciamento de anemia perioperatória melhoram o atendimento ao paciente e reduzem os custos de saúde. O objetivo deste estudo foi identificar o efeito deste programa em pacientes submetidos à artroplastia total de quadril (ATQ) ou joelho (ATJ), na taxa de transfusão, tempo de internação hospitalar e eventos adversos.   Métodos Um estudo observacional retrospectivo foi realizado, incluindo pacientes submetidos a ATQ ou ATJ primária. O programa abrangeu avaliação pré-operatória, o uso de 2 doses de ácido tranexâmico, a aplicação de transfusões restritas e o uso de ferro suplementar. Os resultados foram comparados entre os pacientes antes e após a implementação do protocolo.   Resultados 179 pacientes (80 ATJ e 99 ATQ) foram incluídos pré-protocolo entre janeiro e dezembro de 2014 (grupo A) e 187 casos (103 ATJ e 84 ATQ) pós-protocolo entre janeiro e novembro de 2016 (grupo B). No grupo A, a queda na hemoglobina foi maior do que no grupo B no ATJ (5,1±1,2 vs. 4,2±1,2g/dl; p<0,05) e no ATQ (4,7±1,3 vs. 3,8±1,3g/dl; p<0,05). Houve maior necessidade de transfusão no grupo A (31,8% vs. 2,7%; p<0,001). O tempo de internação foi maior no grupo A para ambas as cirurgias (no ATJ 3,98±1,4dias vs. 2,99±0,95dias; p<0,0001; no ATQ 3,68±1,06dias vs. 2,88±0,75dias; p<0,0001). Nenhuma diferença significativa foi encontrada em relação aos eventos adversos. Conclusão Em ambas as artroplastias, nosso programa diminuiu o número de transfusões, a queda da hemoglobina e o tempo de internação, sem aumentar o número de complicações. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-06-28 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/30134 10.31053/1853.0605.v78.n2.30134 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. 2 (2021); 110-117 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. 2 (2021); 110-117 Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. 2 (2021); 110-117 1853-0605 0014-6722 10.31053/1853.0605.v78.n2 spa https://revistas.unc.edu.ar/index.php/med/article/view/30134/33562 https://revistas.unc.edu.ar/index.php/med/article/view/30134/33565 Derechos de autor 2021 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0

Ejemplares similares