在退伍军人事务医疗中心选择性整体手术后过度使用血红素检测
Anthony Vigil1,2, Taylor Parnall3, Clifford Qualls1,2
1New Mexico Veterans Affairs Health Care System, Albuquerque.
概括
选择性整体手术后的常规术后血红素测试提供了最小的临床益处. 专注于临床判断,先前存在的贫血,高风险的手术或症状可以减少不必要的测试和相关成本.
科学领域:
- 医学研究 医学研究
- 临床实用性评估临床实用性评估
- 卫生经济学 卫生经济学
背景情况:
- 常规的术后血红素检测是选择性整体手术后的常见做法.
- 这种做法的临床有用性和成本效益仍然是调查的对象.
研究的目的:
- 评估选择性整体外科手术后常规术后血红素测试的临床有用性和成本.
- 确定当前的做法是否与患者的治疗结果和资源分配保持一致.
主要方法:
- 在退伍军人事务医院从2011年至2014年进行了回顾性图表审查.
- 收集的数据包括患者人口统计,并发症,估计的血液损失 (EBL),术前和术后血红素水平,以及术后72小时内输血状态.
主要成果:
- 在1531名患者中,只有288名患者的术后血红素水平被测量.
- 只有12名患者 (0.8%) 接受了输血,其中11名患者有显著的血液损失或贫血症状.
- 输血的危险因素包括手术前血红素的降低,EBL的增加以及特定的高风险手术.
结论:
- 选择性整体手术后的常规术后血红素测量可以忽略不计的临床价值.
- 测试应以临床判断,先前存在的贫血,高风险手术或贫血症状为指导.
- 这种方法可以显著减少不必要的实验室测试.
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