Transfusion trend in total hip arthroplasty following the implementation of a Patient Blood Management protocol
Introduction Total hip arthroplasty is a successful and safe surgical procedure, but it involves an associated blood loss. When this surgery is carried out on a scheduled basis, the implantation of a multimodal approach of Patient Blood Management (PBM) will significantly reduce transfusion needs. O...
| Autores principales: | , , , |
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2020
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| Materias: | |
| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/26515 |
| Aporte de: |
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I10-R327-article-26515 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
hip; blood transfusion ; arthroplasty cadera; transfusión sanguínea; artroplastia quadril; transfusão de sangue; artroplastia |
| spellingShingle |
hip; blood transfusion ; arthroplasty cadera; transfusión sanguínea; artroplastia quadril; transfusão de sangue; artroplastia Pinilla-Gracia, Cristian Martín-Hernández, Carlos Panisello Sebastiá, Juan José Mateo Agudo, Jesús Javier Transfusion trend in total hip arthroplasty following the implementation of a Patient Blood Management protocol |
| topic_facet |
hip; blood transfusion ; arthroplasty cadera; transfusión sanguínea; artroplastia quadril; transfusão de sangue; artroplastia |
| author |
Pinilla-Gracia, Cristian Martín-Hernández, Carlos Panisello Sebastiá, Juan José Mateo Agudo, Jesús Javier |
| author_facet |
Pinilla-Gracia, Cristian Martín-Hernández, Carlos Panisello Sebastiá, Juan José Mateo Agudo, Jesús Javier |
| author_sort |
Pinilla-Gracia, Cristian |
| title |
Transfusion trend in total hip arthroplasty following the implementation of a Patient Blood Management protocol |
| title_short |
Transfusion trend in total hip arthroplasty following the implementation of a Patient Blood Management protocol |
| title_full |
Transfusion trend in total hip arthroplasty following the implementation of a Patient Blood Management protocol |
| title_fullStr |
Transfusion trend in total hip arthroplasty following the implementation of a Patient Blood Management protocol |
| title_full_unstemmed |
Transfusion trend in total hip arthroplasty following the implementation of a Patient Blood Management protocol |
| title_sort |
transfusion trend in total hip arthroplasty following the implementation of a patient blood management protocol |
| description |
Introduction
Total hip arthroplasty is a successful and safe surgical procedure, but it involves an associated blood loss. When this surgery is carried out on a scheduled basis, the implantation of a multimodal approach of Patient Blood Management (PBM) will significantly reduce transfusion needs.
Objective
To present the clinical-analytical results and the transfusion incidence after the implantation of a PBM protocol in those patients who are going to undergo prosthetic hip surgery.
Material and methods
Restrospective, unicentric, observational and analytical study, among those patients undergoing primary elective hip arthroplasty between January 2017 and February 2019. In all of them, a PBM protocol has been applied, focused on the development of an optimization program of preoperative anemia, the use of topical tranexamic acid and the adoption of a restrictive transfusion policy.
Results
The study included a total of 384 patients, where only 9 required allogeneic blood transfusion (transfusion rate: 2.34%). In the analysis of transfused patients, they were found to have a longer hospital stay (8 ± 2.9 Vs 5.3 ± 2.9 days; p = 0.007) and a higher rate of complications (22.2% vs. 3, 9%; p = 0.017), with respect to those who avoided the TSA.
Conclusion
The application of an adequate multimodal protocol of PBM, brings us closer to the utopia of bloodless surgery in prosthetic surgery, resulting in a cost-effective model that significantly reduces the TSA in primary hip arthroplasty. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2020 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/26515 |
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I10-R327-article-265152024-08-27T18:27:03Z Transfusion trend in total hip arthroplasty following the implementation of a Patient Blood Management protocol Tendencia transfusional en la artroplastia total de cadera tras la implantación de un protocolo de “Patient Blood Management” Tendência da transfusão na artroplastia total do quadril após a implementação de um protocolo "Patient Blood Management" Pinilla-Gracia, Cristian Martín-Hernández, Carlos Panisello Sebastiá, Juan José Mateo Agudo, Jesús Javier hip; blood transfusion ; arthroplasty cadera; transfusión sanguínea; artroplastia quadril; transfusão de sangue; artroplastia Introduction Total hip arthroplasty is a successful and safe surgical procedure, but it involves an associated blood loss. When this surgery is carried out on a scheduled basis, the implantation of a multimodal approach of Patient Blood Management (PBM) will significantly reduce transfusion needs. Objective To present the clinical-analytical results and the transfusion incidence after the implantation of a PBM protocol in those patients who are going to undergo prosthetic hip surgery. Material and methods Restrospective, unicentric, observational and analytical study, among those patients undergoing primary elective hip arthroplasty between January 2017 and February 2019. In all of them, a PBM protocol has been applied, focused on the development of an optimization program of preoperative anemia, the use of topical tranexamic acid and the adoption of a restrictive transfusion policy. Results The study included a total of 384 patients, where only 9 required allogeneic blood transfusion (transfusion rate: 2.34%). In the analysis of transfused patients, they were found to have a longer hospital stay (8 ± 2.9 Vs 5.3 ± 2.9 days; p = 0.007) and a higher rate of complications (22.2% vs. 3, 9%; p = 0.017), with respect to those who avoided the TSA. Conclusion The application of an adequate multimodal protocol of PBM, brings us closer to the utopia of bloodless surgery in prosthetic surgery, resulting in a cost-effective model that significantly reduces the TSA in primary hip arthroplasty. Introducción La artroplastia total de cadera es un procedimiento quirúrgico exitoso y seguro, pero que conlleva una inherente perdida sanguínea asociada. Cuando esta cirugía se lleva a cabo de forma programada, la implantación de un abordaje multimodal de Patient Blood Management (PBM), permitirá reducir significativamente las necesidades transfusionales. Objetivo Presentar los resultados clínico-analíticos y la incidencia transfusional tras la implantación de un protocolo de PBM en aquellos pacientes que van a someterse a una cirugía protésica de cadera. Material y métodos Estudio restrospectivo, unicentrico, observacional y analítico, entre aquellos pacientes sometidos a una artroplastia primaria de cadera electiva entre enero de 2017 y Febrero de 2019. En todos ellos, se ha aplicado un protocolo de PBM, centrado en el desarrollo de un programa de optimización de la anemia preoperatoria, la utilización de ácido tranexámico tópico y la adopción de una política transfusional restrictiva. Resultados El estudio incluyó un total de 384 pacientes, donde únicamente 9 precisaron transfusión de sangre alogénica (Tasa transfusional: 2,34%). En el análisis de los pacientes transfundidos, se encontró que presentaban una mayor estancia hospitalaria (8 ±2,9 Vs 5,3 ±2,9 días; p=0,007) y un mayor índice de complicaciones (22,2% vs 3,9%; p=0,017), respecto a aquellos que eludieron la TSA. Conclusión La aplicación de un adecuado protocolo multimodal de PBM, nos acerca a la utopía de una cirugía sin sangre en la cirugía protésica, resultando un modelo costo-efectivo que permite reducir de forma significativa la TSA en la artroplastia primaria de cadera. Introdução A artroplastia total do quadril é um procedimento cirúrgico bem-sucedido e seguro, mas envolve uma perda de sangue associada. Quando esta cirurgia é realizada de forma programada, o implante de uma abordagem multimodal de “Patient Blood Management” (PBM) reduzirá significativamente as necessidades de transfusão. Objetivo Apresentar os resultados clínico-analíticos e a incidência de transfusões após o implante de um protocolo PBM nos pacientes submetidos à cirurgia protética do quadril. Material e métodos Estudo retrospectivo, unicêntrico, observacional e analítico, entre os pacientes submetidos à artroplastia primária eletiva do quadril entre janeiro de 2017 e fevereiro de 2019. Em todos eles, foi aplicado um protocolo PBM, focado no desenvolvimento de um programa de otimização anemia pré-operatória, uso de ácido tranexâmico tópico e adoção de política restritiva de transfusão. Resultados O estudo incluiu um total de 384 pacientes, sendo que apenas 9 necessitaram de transfusão de sangue alogênico (taxa de transfusão: 2,34%). Na análise dos pacientes transfundidos, constatou-se maior tempo de internação (8 ± 2,9 Vs 5,3 ± 2,9 dias; p = 0,007) e maior taxa de complicações (22,2% vs. 3, 9%; p = 0,017), em relação aos que evitaram a TSA. Conclusão A aplicação de um protocolo multimodal adequado da PBM nos aproxima da utopia da cirurgia sem sangue na cirurgia protética, resultando em um modelo de baixo custo que reduz significativamente o TSA na artroplastia primária do quadril. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020-03-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/26515 10.31053/1853.0605.v77.n1.26515 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 77 No. 1 (2020); 39-44 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 77 Núm. 1 (2020); 39-44 Revista da Faculdade de Ciências Médicas de Córdoba; v. 77 n. 1 (2020); 39-44 1853-0605 0014-6722 10.31053/1853.0605.v77.n1 spa https://revistas.unc.edu.ar/index.php/med/article/view/26515/29270 https://revistas.unc.edu.ar/index.php/med/article/view/26515/29272 Derechos de autor 2020 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |