Patient Blood Management
Conditions
Keywords
blood transfusion, orthopedic surgery, coagulation
Brief summary
Aim of this study is to analyze the transfusion requirements of allogenic blood products at the Schulthess Clinic for patients that had major orthopedic or major spine surgery between 2019 and 2024 order to identify patients at risk for transfusion. Moreover, impact of transfusion requirements and other measures of PBM on patient outcomes will be assessed. These data are required to further improve PBM at the Schulthess Clinic.
Detailed description
At the Schulthess Clinic a significant reduction of RBC's, fresh frozen plasma (FFP) and platelets transfusion could be observed between 2018 and 2022 during the stepwise introduction of PBM for all patients undergoing major orthopedic and spine surgery. RBC, FFP and PT transfusion declined by 76.3%, 73.5% and 99.2% over the 5-year period. Unfortunately however, at the moment no detailed analysis with respect to risk factors for transfusion, specific interventions or outcomes is available. The hypothesis is that the already known reduction of allogenic blood product transfusion at the Schulthess Clinic can be attributed to patients undergoing major primary joint arthroplasties, revision operations and major spine surgery. We assume that patient and procedure related risk factors over time did not significantly change while we expect a major impact of changed transfusion requirements and the stepwise PBM implementation on patient outcomes.
Interventions
PROCEDUREPatient blood management
Perioperative optimization of hemoglobin level, perioperative minimization of blood loss, increase of anemia tolerance
Sponsors
Schulthess Klinik
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Patients undergoing primary joint arthroplasties or revision surgery: CHOP Code: 81.51, 81.52, 81.52, 81.54 * Patients undergoing major spine surgery: CHOP Code: 7A.6, 7A.7
Exclusion criteria
* Patients who did not sign general informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Perioperative transfusion rates | 2019-2024 | Administration of red blood cells, fresh frozen plasma and platelet concentrates (units) |
| Risk factors for perioperative transfusion Risk factors for perioperative transfusion Risk factorsfor perioperative transfusion | 2019-2024 | Identification of patient groups with increased transfusion rates |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perioperative rates of coagulation products administered | 2019-2024 | Administration of prothrombin complex, fibrinogen, other coagulation factors |
| Clinical outcomes | 2019-2024 | * Infections: Wound, sepsis, drug-resistant, Clostridium difficilis. * Ischemic events: TIA, cerebrovascular, myocardial * Thrombotic: Deep venous thrombosis (DVT), pulmonary embolism (Barrie et al.) * Renal failure * Pulmonary failure |
Contacts
Primary ContactChristoph K Hofer, MD
Backup ContactJulia Item, PhD
Outcome results
None listed