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 Hun; Shin, Hyeon Ju; You, Hae Sun; Park, Yoonsun; Ahn, Ki Hoon; Jung, Jae Seung; Han, Seung-Beom; Park, Jong Hoon; Korea 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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Collections - 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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