Risk factors for blood transfusion in patients undergoing hip fracture surgery

Abstract

References:1. Martinez V. Transfusion strategy for primary knee and hip arthroplasty: impact of an algorithm to lower transfusion rates and hospital costs. Br J Anaesth. 2007 Dec; 99 (6): 794-800 2. Henry DA et al. Anti-fibrinoly tic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 2007; CD001886Background and Goal of Study: In order to know the availability of a specific Patient Blood Management (PBM) program in dif ferent hospitals in Spain, we designed a survey that included the features of the preoperative evaluation, the availability and design of dif ferent blood-saving techniques in each center and the limiting factors in implementation for dif ferent types of scheduled surgery. Methods / Design: The design the survey was made by the members of the Section of Hemostasis and Transfusion Medicine of the SEDAR (Spanish Society of Anaesthesia) and was distributed through the sales network of Vifor Pharma ® , which provided one for each Department of Anesthesiology in Spanish hospitals during the months of September to November 2012. Results / Discussion: 91 Anaesthesia Departments received the survey and 82 responses were obtained. Preoperative evaluation proceeded normally in 86.6% of hospitals. The time from the pre-anesthetic evaluation for surgery was between one week and two months. 77 hospitals (93.9%) have Transfusion Commit tee, and involving the anesthesiologist participation 90.2%. There is a blood management program in 79.3% of hospitals and the techniques more used were the use of Tranexamic Acid in 75.3% of hospitals, followed by intra-and postoperative blood cell salvage and reinfusion in equal proportion 67%. For treatment of preoperative anaemia, treatment with intravenous iron performs regularly in 39.5%, and occasionally in 60.5% of hospitals, and treatment with ery thropoietin is performed routinely at 28.4%, and occasionally in 65.4% of hospitals. Limiting factors for implementing or improving blood conservation program in hospitals were in order of importance: first, to establish the preoperative optimization circuit (64 centers), second, surgical team collaboration (61 centers), third, the insuf ficient interest of the anesthesiologist (57 centers), and fourth, the economic cost of some techniques (32 centers). Conclusions: The implementation of PBM requires liaison and partnership between all personnel and organizations responsible for perioperative care, including Blood Service authorities. Currently, the implementation of PBM in Spanish is limited. It is hoped that this report also aids the wider implementation of PBM in Spain. References: Basora M, Colomina MJ, Moral V, et al. TATM 2008; 10:9-16. Shander A, Van Aken H, Colomina MJ, et al. Br