输血血红蛋白值:在明智选择的时代,我们的表现如何? 一个回顾性队列研究
Phyranavy Jeganathan-Udayakumar1, Nicole Tochtermann1, Thomas Beck1
1Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Swiss medical weekly
|April 5, 2024
概括
输血做法在医院变得更加严格,与指导方针保持一致. 潜在不充分的红细胞输血减少了,特别是在内部医学中,但老年和慢性疾病等危险因素仍然存在.
科学领域:
- 内部医学 内部医学
- 血液学 血液学 血液学
- 临床实践指南 临床实践指南
背景情况:
- 临床指南建议在稳定的住院患者中,红细胞输血时血红蛋白值为70-80g/l.
- 关于医疗住院患者的输血实践和趋势的数据有限.
研究的目的:
- 研究一般内科和其他医院诊所的输血实践及其趋势.
- 评估遵守严格的输血指南.
主要方法:
- 从2012年至2019年进行红细胞 (RBC) 输血住院病例的回顾性队列研究.
- 分析了输血前的血红蛋白水平,可能不充分的输血 (Hb ≥80 g/l) 和单个红细胞单位的接收.
- 使用通用估计方程来分析趋势和风险因素.
主要成果:
- 在一般内科和其他诊所中,输血前平均血红蛋白下降.
- 在这两种情况下,潜在的不充分输血随着时间的推移显著减少.
- 接受单个红血细胞单位的患者比例大幅增加.
- 高龄,手术,急性出血和慢性疾病是不充分输血的危险因素.
结论:
- 输血实践变得更加严格,这表明人们越来越多地遵守指南和明智选择倡议.
- 干预措施应专注于照顾高风险患者 (老年人,手术,慢性疾病) 的提供者.
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