血输血实践:对23家医院的血输血进行了为期五年的审计
Nadia Gabarin1,2, Phuong Uyen Nguyen3, Na Li3,4
1University Health Network, Toronto, Ontario, Canada.
Transfusion
|September 7, 2025
概括
加拿大各医院的血输血实践有很大差异,在使用和输血前的INR值方面存在很大差异. 制定基于证据的指导方针对于优化医疗和重症监护室的血使用至关重要.
科学领域:
- 血液学
- 输血医学
- 危急护理医学
背景情况:
- 有限的高质量的证据指导了血输血的做法.
- 目前的血输血实践表现出显著的变化.
- 在研究期间,可获得全血和非瑞斯血.
研究的目的:
- 调查加拿大医院血使用的差异.
- 检查血输血前的临界值.
- 鉴定导致血输血实践变化的因素.
主要方法:
- 在23家加拿大医院 (2017 - 2022年) 进行的成人住院患者的回顾性队列研究.
- 数据包括患者的人口统计,诊断,手术,实验室检查和输血细节.
- 缺少血数据或凝血测试的部位被排除.
主要成果:
- 分析了超过95万例入院病例,其中包括使用血的11,163例 (46,377单元).
- 在各医院和各专科中,每1000个住院日输血的血单位 (0. 2 - 11. 0) 和输血前的INR值有显著的变化.
- 在研究期间,整体血利用率没有显著变化.
结论:
- 血利用率和输血前的INR值在机构和医生专业之间表现出相当大的差异.
- 这些发现强调需要基于证据的指导方针来规范和优化血输血.
- 有效的知识转化策略对于改善血输血实践至关重要.
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