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德国患者血液管理网络:对120万患者的有效性和安全性分析

Patrick Meybohm¹, Elke Schmitt², Suma Choorapoikayil³

¹Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany; University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany.

British journal of anaesthesia

|June 28, 2023

概括

患者血液管理 (PBM) 在超过一百万的手术患者中显著减少了红细胞输血. 这种基于证据的方法实现了安全非劣势目标,证明了其在改善患者结果方面的有效性.

科学领域:

在外科手术期间的医学.
输血医学输血医学
医疗保健服务研究医疗服务研究

背景情况:

患者血液管理 (PBM) 是一种系统的,以患者为中心的策略,通过管理患者自己的血液来优化结果.
以前的研究还没有广泛研究PBM的长期有效性和安全性.

研究的目的:

评估手术患者患者血液管理 (PBM) 的长期有效性和安全性.
评估PBM对血液产品利用,患者安全和临床结果的影响.

主要方法:

进行了一项多中心的前性后续研究,其设计不低劣.
从电子健康记录回顾分析了超过120万名成年手术患者 (2010-2019) 的数据.
PBM的实施重点是手术前的血红蛋白优化,节血技术和输血指南的遵守.

主要成果:

实施PBM导致红细胞 (RBC) 使用率相对减少13.9% (每1000名患者中有547个单位,而每1000名患者中有635个单位).
在PBM队列中,红细胞输血率明显较低 (OR 0.86;P<0.001).
住院死亡率和术后并发症的综合终点显示非劣势 (5.8%PBM对比5.6%前PBM;P<0.001).

结论:

患者血液管理在大量的外科患者中是安全和有效的,符合患者安全的非劣等标准.
在减少红细胞输血方面,PBM表现出优越性,突出了其在术后护理中的价值.

关键词:

贫血贫血贫血是一种疾病.输血输血输血输血输血临床结果临床结果患者的血液管理患者的血液管理患者安全患者安全在外科手术期间的护理.红细胞是红血细胞的组成部分.

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