Anemia, Blood Loss Anemia, Blood Loss, Surgical, Blood Transfusion, Coagulation Disorder, Surgery
Conditions
Brief summary
The aim of this study is to describe the transfusion practices in patients undergoing major surgery in Turkey. The transfusion rates of red blood cells (RBC), fresh frozen plasma (FFP) and platelets; the transfusion predictors and transfusion related patient outcomes are investigated.
Detailed description
Patient Blood Management (PBM) is an evidence based multidisciplinary approach for the care of patients who may need blood transfusion. The aim of PBM is achieving better patient outcomes by focusing on the patients' own blood as a source. To date PBM is considered good transfusion practice and is being implemented in a growing number of countries. The Turkish Society of Anesthesiologists PBM Task Force is working on this subject since 4 years and decided to conduct a study. Before starting a PBM program, the transfusion practices of clinicians working at diverse surgical fields; differences between current transfusion practices and PBM strategies; the areas for improvement and the obstacles that could prevent change could be identified with this study. Data collection will also serve to identify the current situation as a reference and to control the achievement of the PBM's aim: improving clinical outcomes. These data will be refered as The Turkish National Perioperative Transfusion Study (TULIP TS) data. The aim of this study is to describe the transfusion practices in patients undergoing major surgery in Turkey. The study evaluates i. The perioperative transfusion rates of RBCs, FFP and platelets. ii. With which reasons the anesthesiologists decide to transfuse a patient (co morbidities of the patients, physiologic transfusion triggers, hemoglobin trigger, uncontrolled bleeding, on request from surgeon etc.). iii. The relation of transfusion and the patients co-morbidity index, the P POSSUM score and SORT score; anesthesia methods; monitorisation methods (hemodynamic, coagulation); amount of bleeding; type of surgery; type of hospital. iv. The relation of transfusion and patient outcomes (unanticipated ICU admission, prolonged ICU stay, acute renal failure, thromboembolic events, ischemic events, pulmonary complications, cardiac advers events, infections, acute respiratory distress, infection, all-cause mortality).
Interventions
OTHERBlood transfusion
Transfusion of blood products in the perioperative period in patients undergoing major surgery
Sponsors
Turkish Society of Anesthesiology and Reanimation
Diskapi Teaching and Research Hospital
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
Patients undergoing major elective surgery
Exclusion criteria
Trauma patients, emergency surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Preoperative amount of blood products transfused | Before surgery at day 0 | Preoperative amount of blood products: RBCs,FFP and platelets transfused |
| Intraoperative amount of blood products transfused | During surgery at day 0 | Intraoperative amount of blood products: RBC's,FFP and platelets transfused |
| Postoperative amount of blood products transfused | 24 hours after surgery | Postoperative amount of blood products: RBCs,FFP and platelets transfused |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Unanticipated ICU admission | After surgery at day 1 | Whether the patient had an unanticipated ICU admission |
| Prolonged length of stay in ICU | After surgery at day 2 | Whether the patient had a prolonged length of stay in ICU |
| Acute renal failure | After surgery at day 2 | Whether the patient had acute renal failure |
| Thromboembolic event | After surgery at day 2 | Whether the patient had a thromboembolic event concerning lungs (pulmonary embolism), brain (stroke), gastrointestinal tract, kidneys, or extremities etc. |
| Ischemic event | After surgery at day 2 | Whether the patient had an ischemic event concerning heart, nervous system,limb, gastrointestinal tract etc. |
| Infection | After surgery at day 2 | Whether the patient had infection: wound, pneumonia, urinary, sepsis etc. |
| Postoperative transfusion indications | 24 hours after surgery | The reasons to decide to transfuse (factors determining transfusion) blood products |
| Mortality | after surgery at day 30 | Whether the patient died: all cause mortality |
| Preoperative anemia | Before surgery at day 0 | Whether the patient had anemia (Hemoglobin male \< 13 female \< 12 g/dL) |
| Preoperative coagulopathy | Before surgery at day 0 | Whether the patient had coagulopathy due to disease or drugs |
| Pretransfusion hemoglobin values | Before surgery at day 0 | The hemoglobin concentration before transfusion |
| Advers cardiac events | After surgery at day 30 | Whether the patient had an advers cardiac event: myocardial infaction; non fatal cardiac arest; arrhytmia; cardiogenic pulmonary edema etc |
| Acute respiratory distress | After surgery at day 2 | Whether the patient had acute respiratory distress |
| Preoperative transfusion indications | Before surgery at day 0 | The reasons to decide to transfuse (factors determining transfusion) blood products |
| Intraoperative transfusion indications | During surgery at day 1 | The reasons to decide to transfuse (factors determining transfusion) blood products |
Countries
Turkey (Türkiye)
Outcome results
None listed