Adjusted transfusion triggers improve transfusion practice in orthopaedic surgery

Area of Science:

• Transfusion Medicine
• Surgical Patient Care

Background:

• Despite advancements, concerns persist regarding adverse effects of blood transfusions.
• Optimizing transfusion decisions is crucial for patient safety and resource management.

Purpose of the Study:

• To evaluate the efficacy of the novel 6-8-10-Flexinorm guidelines in reducing allogeneic blood use.
• To assess the impact of these guidelines on transfusion rates in patients undergoing elective primary total hip replacement.

Main Methods:

• A case-control study was conducted in two hospitals, with one implementing the guidelines (Hospital A) and the other serving as a control (Hospital B).
• The study involved two phases: active guideline implementation and passive registration.
• Packed red cell (PRC) utilization and the percentage of transfused patients were compared pre- and post-guideline introduction.

Main Results:

• Hospital A showed a significant decrease in PRC use per patient (from 1.1 to 0.6 and 0.3 units) and a reduction in transfused patients (from 43% to 27% and 14%).
• In contrast, Hospital B (control) exhibited no significant change in PRC use or transfusion rates.
• The guidelines led to a marked reduction in allogeneic blood consumption and the number of patients requiring transfusion.

Conclusions:

• The 6-8-10-Flexinorm guidelines are effective in reducing allogeneic blood transfusion and the number of transfused patients.
• Implementation of evidence-based transfusion guidelines can optimize blood management in surgical settings.
• These findings support the adoption of the 6-8-10-Flexinorm guidelines for improving transfusion practices.