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Open Access 30-10-2022 | Anemia | Original Article

Implementation of a patient blood management in an Italian City Hospital: is it effective in reducing the use of red blood cells?

Authors: Giorgio Ercolani, Leonardo Solaini, Fabrizio D’Acapito, Claudio Isopi, Carlo Alberto Pacilio, Cinzia Moretti, Vanessa Agostini, Alessandro Cucchetti

Published in: Updates in Surgery | Issue 1/2023

Abstract

To evaluate the effect of patient blood management (PBM) since its introduction, we analyzed the need for transfusion and the outcomes in patients undergoing abdominal surgery for different types of tumor pre- and post-PBM. Patients undergoing elective gastric, liver, pancreatic, and colorectal surgery between 2017 and 2020 were included. The implementation of the PBM program was completed on May 1, 2018. The patients were grouped as follows: those who underwent surgery before the implementation of the program (pre-PBM) versus after the implementation (post-PBM). A total of 1302 patients were included in the analysis (445 pre-PBM vs. 857 post-PBM). The number of transfused patients per year decreased significantly after the introduction of PBM. A strong tendency for a decreased incidence of transfusion was evident in gastric and pancreatic surgery and a similar decrease was statistically significant in liver surgery. With regard to gastric surgery, a single-unit transfusion scheme was used more frequently in the post-PBM group (7.7% vs. 55% after PBM; p = 0.049); this was similar in liver surgery (17.6% vs. 58.3% after PBM; p = 0.04). Within the subgroup of patients undergoing liver surgery, a significant reduction in the use of blood transfusion (20.5% vs. 6.7%; p = 0.002) and a decrease in the Hb trigger for transfusion (8.5, 8.2–9.5 vs. 8.2, 7.7–8.4 g/dl; p = 0.039) was reported after the PBM introduction. After the implementation of a PBM protocol, a significant reduction in the number of patients receiving blood transfusion was demonstrated, with a strong tendency to minimize the use of blood products for most types of oncologic surgery.

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Title: Implementation of a patient blood management in an Italian City Hospital: is it effective in reducing the use of red blood cells?
Authors: Giorgio Ercolani
Leonardo Solaini
Fabrizio D’Acapito
Claudio Isopi
Carlo Alberto Pacilio
Cinzia Moretti
Vanessa Agostini
Alessandro Cucchetti
Publication date: 30-10-2022
Publisher: Springer International Publishing
Keywords: Anemia
Pancreatic Surgery
Pancreatic Surgery
Liver Surgery
Gastric Surgery
Abdominal Surgery
Liver Surgery
Gastric Surgery
Minimally Invasive Surgery
Published in: Updates in Surgery / Issue 1/2023
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-022-01409-z

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Implementation of a patient blood management in an Italian City Hospital: is it effective in reducing the use of red blood cells?

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