Impact of a patient blood management program within an Orthogeriatric care service

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dc.contributor.author Bielza Galindo, Rafael
dc.contributor.author Mora Casado, Asunción
dc.contributor.author Zambrana Tevar, Francisco
dc.contributor.author Sanjurjo Portus, Jorge
dc.contributor.author Sanz Rosa, David
dc.contributor.author Thuissard Vasallo, Israel John
dc.contributor.author Arias Muñana, Estefanía
dc.contributor.author Neira Álvarez, Marta
dc.contributor.author Gómez Cerezo, Jorge Francisco
dc.date.accessioned 2018-07-20T13:44:13Z
dc.date.available 2018-07-20T13:44:13Z
dc.date.issued 2018
dc.identifier.citation Bielza, R., Mora, A., Zambrana, F., Sanjurjo, J., Sanz Rosa, D., Thuissard Vasallo, I. J., ... & Gómez Cerezo, J. F. (2018). Impact of a patient blood management program within an Orthogeriatric care service. Transfusion and Apheresis Science. 57(4), 517-523. https://doi.org/10.1016/j.transci.2018.05.029 spa
dc.identifier.issn 1473-0502
dc.identifier.uri http://hdl.handle.net/11268/7340
dc.description.abstract Patient blood management (PBM) performs multidisciplinary strategies to optimize red blood cell (RBC) transfusion. Orthogeriatric share care models (surgeon and geriatrician manage the patient together from admission) have the goal of improving outcomes in hip fracture patients. MATERIAL AND METHODS: A prospective observational study was conducted. Patients aged ≥70 years undergoing hip fracture (HF) surgery were consecutively included. When admitted on the orthogeriatric service a PBM protocol was applied based on: perioperative antithrombotic management, intravenous iron sucrose administration and restrictive transfusion criteria. Risk factors, clinical and functional effects of transfusion and its requirements were assessed to audit our model. RESULTS: A total of 383 patients participated (women, 78.8%; median age, 86 (82-90) years). 210 patients (54.8%) were transfused. Age (OR = 1.055, 95% CI 1.017-1.094; p = 0.004) and Hemoglobin (Hb) level on admission (OR = 0.497, 95% CI 0.413-0.597; p < 0.001) were found to be significant risk factors for transfusion. Transfusion increased length of stay (b = 1.37, 95% CI 0.543-2.196; p = 0.001) but did not have an effect on other variables. DISCUSSION: The PBM program established within an orthogeriatric service showed positive outcomes in terms of clinical complications, mortality, delirium or functional recovery in transfused patients, whereas it did not impact on shorter length of stay. The risk of transfusion on admission was predicted with the lower Hb levels on admission, along with the age of the patients. New measurements as homogenous restrictive transfusion criteria, a single-unit RBC transfusion and the assessment of the intravenous iron efficacy are need to be applied as a result of the high transfusion requirements. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.subject.other Hip fracture spa
dc.subject.other Orthogeriatric service spa
dc.title Impact of a patient blood management program within an Orthogeriatric care service spa
dc.type article spa
dc.description.impact 1.755 JCR (2017) Q4, 56/71 Hematology spa
dc.identifier.doi 10.1016/j.transci.2018.05.029
dc.rights.accessRights closedAccess spa
dc.subject.uem Geriatría spa
dc.subject.unesco Tratamiento médico spa
dc.subject.unesco Gerontología spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa

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