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

• Published in: Transfusion and apheresis science 2018-08, Vol.57 (4), p.517-523
• Main Authors: Bielza, Rafael, Mora, Asunción, Zambrana, Francisco, Sanjurjo, Jorge, Sanz-Rosa, David, Thuissard, Israel J., Arias, Estefanía, Neira, Marta, Gómez Cerezo, Jorge Francisco
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; Delivery of Health Care, Integrated - organization & administration; Erythrocyte Transfusion - methods; Female; Health Services for the Aged - organization & administration; Health technology assessment; Hip fracture; Humans; Male; Orthogeriatric service; Patient blood management; Red blood cell transfusión
• ISSN: 1473-0502; 1878-1683
• DOI: 10.1016/j.transci.2018.05.029

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. 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. 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