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Effect of a Patient Blood Management Program on the Appropriateness of Red Blood Cell Transfusion and Clinical Outcomes in Elderly Patients Undergoing Hip Fracture Surgeryopen accessEffect of a Patient Blood Management Program on the Appropriateness of Red Blood Cell Transfusion and Clinical Outcomes in Elderly Patients Undergoing Hip Fracture Surgery

Other Titles
Effect of a Patient Blood Management Program on the Appropriateness of Red Blood Cell Transfusion and Clinical Outcomes in Elderly Patients Undergoing Hip Fracture Surgery
Authors
Kim, Jong HunShin, Hyeon JuYou, Hae SunPark, YoonsunAhn, Ki HoonJung, Jae SeungHan, Seung-BeomPark, Jong HoonKorea Univ Bloodless Med Ctr Sci Comm
Issue Date
Feb-2023
Publisher
대한의학회
Keywords
Aged; Patient Outcome Assessment; Erythrocyte Transfusion; Hip Fractures; Program Evaluation; Risk Factors
Citation
Journal of Korean Medical Science, v.38, no.8, pp 1 - 13
Pages
13
Indexed
SCIE
SCOPUS
KCI
Journal Title
Journal of Korean Medical Science
Volume
38
Number
8
Start Page
1
End Page
13
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62749
DOI
10.3346/jkms.2023.38.e64
ISSN
1011-8934
1598-6357
Abstract
Background Elderly patients with hip fractures frequently receive perioperative transfusions, which are associated with increased morbidity and mortality. This study aimed to evaluate the impact of a patient blood management (PBM) program on the appropriateness of red blood cell (RBC) transfusion and clinical outcomes in geriatric patients undergoing hip fracture surgery. Methods In 2018, the revised PBM program was implemented at the Korea University Anam Hospital, Seoul, Republic of Korea. Elderly patients aged ≥ 65 years who underwent hip fracture surgery from 2017 to 2020 were evaluated. Clinical characteristics and outcomes were analyzed according to the timing of PBM implementation (pre-PBM, early-PBM, and late-PBM). Multiveriate regression analysis was used to evaluate the risk factors of the adverse outcomes, such as in-hospital mortality or 30-day readmission. Results A total of 884 elderly patients were included in this study. The proportion of patients who received perioperative RBC transfusions decreased significantly (43.5%, 40.1%, and 33.2% for pre-PBM, early-PBM, and late-PBM, respectively; P = 0.013). However, the appropriateness of RBC transfusion significantly increased (54.0%, 60.1%, and 94.7%, respectively; P < 0.001). The duration of in-hospital stay and 30-day readmission rates significantly decreased. Multivariable regression analysis revealed that RBC transfusion (odds ratio, 1.815; 95% confidence interval, 1.137–2.899; P = 0.013) was significantly associated with adverse outcomes. Conclusion Implementing the PBM program increased the appropriateness of RBC transfusion without compromising transfusion quality and clinical outcomes. Therefore, adopting the PBM program may improve the clinical management of elderly patients following hip fracture surgery.
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2. Clinical Science > Department of Orthopedic Surgery > 1. Journal Articles
2. Clinical Science > Department of Thoracic and Cardiovascular Surgery > 1. Journal Articles
2. Clinical Science > Department of Obstetrics and Gynecology > 1. Journal Articles
2. Clinical Science > Department of Anesthesiology and Pain Medicine > 1. Journal Articles

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Shin, Hyeon Ju
Anam Hospital (Department of Anesthesiology and Pain Medicine, Anam Hospital)
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