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Fewer blood transfusions seen with patient blood management program for joint arthroplasty
Results from this study demonstrated a reduction in the percentage of patients who were transfused and better outcomes with the implementation of a patient blood management program for prosthetic joint arthroplasty.
Researchers retrospectively compared the results of 5,997 consecutive patients who underwent either primary or revision total hip or knee arthroplasty to those of 6,593 consecutive patients who underwent these procedures after the implementation of a patient blood management program, in which hemodynamically stable patients (with a heart rate of no greater than 100 beats per minute and with a systolic blood pressure ≥100 mm Hg) were not transfused with allogeneic packed red blood cells (PRBCs) if their hemoglobin levels reached above 7 g/dL. Investigators measured the percentage of patients who received blood transfusions as the primary study outcome.
Results showed that from the baseline period to the study period, tranexamic acid use significantly increased from 4.9% to 26.9% and the use of navigation increased from 14.3% to 20.2%. Investigators noted a 44% decrease in the percentage of patients who were transfused during the study period of PBM program compared with the baseline period. Compared with the baseline period, the study period showed a 41.3% decrease in the number of units transfused per 1,000 patients. Complications, 30-day readmissions, and hospital length of stay also showed significant decreases during the study period compared with the baseline period.
Transfusion rate and tranexamic acid use were significantly correlated. However, investigators wrote that a collinearity issue was not found, “demonstrating that tranexamic acid and the PBM program were independently associated with a decreased transfusion rate.” ‒ by Monica Jaramillo
Disclosures: Loftus reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.