1. Peri-operative blood transfusion in elective major surgery: incidence, indications and outcome - an observational multicentre study.
- Author
-
Unal D, Senayli Y, Polat R, Spahn DR, Toraman F, Alkis N, Zekeriyya A, Bahar A, Onat BA, Hulya B, Mehmet B, Nesil C, Asli D, Suna G, Meltem GC, Mukadder O, Mert S, Busra T, Ilksen TH, Cigdem YG, Suheyla A, Yesim A, Arzu AE, Esra AT, Ali A, Mine A, Nukhet A, Mustafa AS, Ergin A, Cavidan AM, Sule A, Gulbin AA, Emine A, Esma A, Mahmut A, Necmiye A, Zuhal A, Hilal A, Cumhur B, Volkan B, Nurdan B, Azize B, Zekiye B, Ugur BM, Faruk BO, Sibel B, Sanem CT, Meltem C, Baris C, Ayse C, Zubeyir C, Banu CEF, Faruk C, Alkin C, Ziya CY, Esra D, Fisun DH, Abdurrahim D, Ayca DO, Osman E, Gulay EK, Engin E, Ipek E, Tekeli AE, Mehmet G, Basak G, Gamze G, Emel G, Isin G, Betul GA, Gulcin H, Nazan HS, Ozgen IK, Ayse IE, Muzeyyen I, Inci K, Deniz K, Derya K, Arzu K, Duygu KA, Mensure K, Suleyman K, Zuleyha KB, Gulsen K, Oya K, Yeliz K, Pakize K, Zeynep K, Ceren K, Betul K, Semih K, Gamze K, Ilke K, Aysun K, Omer K, Ceyda MB, Burak N, Dilek OR, Dilek O, Yavuz O, Elif O, Esra Ö, Menekse O, Sabri OE, Yetkin O, Aysegul O, Ozgur OM, Onur O, Ozlem S, Arzu S, Aslinur S, Mehmet S, Cihan S, Yeliz S, Nevriye S, Ayten S, Tolga SK, Hilal S, Gokce SS, Betul S, Ozlem S, Bengi SE, Isil SF, Emin S, Dilek SF, Ebru TK, Nilay T, Tuncel TZ, Sibel T, Gonul TK, Hulya T, Abdurrahman T, Fatih U, Canan U, Petek U, Suheyla U, Gulcin US, Filiz U, Selcan YA, Kadir Y, Mustafa Y, Aysun YA, Munise Y, Hatice YE, Hakan Y, Mehmet Y, and Nureddin Y
- Subjects
- Adult, Aged, Cross-Sectional Studies, Female, Humans, Incidence, Male, Middle Aged, Prospective Studies, Turkey, Blood Component Transfusion, Elective Surgical Procedures, Perioperative Care
- Abstract
Background: Patients' demographic and epidemiological characteristics, local variations in clinicians' knowledge and experience and types of surgery can influence peri-operative transfusion practices. Sharing data on transfusion practices and recipients may improve patients' care and implementation of Patient Blood Management (PBM)., Materials and Methods: This was a multicentre, prospective, observational, cross-sectional study that included 61 centres. Clinical and transfusion data of patients undergoing major elective surgery were collected; transfusion predictors and patients' outcomes were analysed., Results: Of 6,121 patients, 1,579 (25.8%) received a peri-operative transfusion. A total of 5,812 blood components were transfused: red blood cells (RBC), fresh-frozen plasma and platelets in 1,425 (23.3%), 762 (12.4%) and 88 (1.4%) cases, respectively). Pre-operative anaemia was identified in 2,019 (33%) patients. Half of the RBC units were used by patients in the age group 45-69 years. Specific procedures with the highest RBC use were coronary artery bypass grafting (16.9% of all units) and hip arthroplasty (14.9%). Low haemoglobin concentration was the most common indication for intra-operative RBC transfusion (57%) and plasma and platelet transfusions were mostly initiated for acute bleeding (61.3% and 61.1%, respectively). The RBC transfusion rate in study centres varied from 2% to 72%. RBC transfusion was inappropriate in 99% (n=150/151) of pre-operative, 23% (n=211/926) of intra-operative and 43% (n=308/716) of post-operative RBC transfusion episodes. Pre-operative haemoglobin, increased blood loss, open surgery and duration of surgery were the main independent predictors of intra-operative RBC transfusion. Low pre-operative haemoglobin concentration was independently associated with post-operative pulmonary complications., Conclusions: These findings identified areas for improvement in peri-operative transfusion practice and PBM implementation in Turkey.
- Published
- 2020
- Full Text
- View/download PDF