A clinical audit of the utilisation of red cell products in elective total hip replacement surgery
Previous studies have documented a marked variation in transfusion practice for total hip replacement (THR) surgery. To audit red cell product utilisation for THR at two Western Cape tertiary referral hospitals (HY and HG). The folders of 207 consecutive patients undergoing elective THR surgery from...
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| Veröffentlicht in: | SAMJ: South African Medical Journal 2016-08, Vol.106 (8), p.824-828 |
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| creator | Peters, Yvonne Grace Bird, Arthur Bellairs, Greg R M Davison, Glenda Mary |
| description | Previous studies have documented a marked variation in transfusion practice for total hip replacement (THR) surgery.
To audit red cell product utilisation for THR at two Western Cape tertiary referral hospitals (HY and HG).
The folders of 207 consecutive patients undergoing elective THR surgery from January 2013 to December 2013 were reviewed. Information relating to age, sex, clinical observations, indications for surgery, pre- and postoperative haemoglobin (Hb) values, comorbidities, length of hospital stay and transfusion history was recorded.
The transfusion rate at HY (41.6%) was significantly higher than that at HG (10.0%). The mean postoperative Hb in the transfused patients at HG was 8.3 g/dL v. 9.1 g/dL at HY. Females had a significantly higher transfusion rate (33.0%) than males (15.0%) (p |
| doi_str_mv | 10.7196/SAMJ.2016.v106i8.10566 |
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To audit red cell product utilisation for THR at two Western Cape tertiary referral hospitals (HY and HG).
The folders of 207 consecutive patients undergoing elective THR surgery from January 2013 to December 2013 were reviewed. Information relating to age, sex, clinical observations, indications for surgery, pre- and postoperative haemoglobin (Hb) values, comorbidities, length of hospital stay and transfusion history was recorded.
The transfusion rate at HY (41.6%) was significantly higher than that at HG (10.0%). The mean postoperative Hb in the transfused patients at HG was 8.3 g/dL v. 9.1 g/dL at HY. Females had a significantly higher transfusion rate (33.0%) than males (15.0%) (p<0.05), and the mean age of transfused patients was significantly greater than that of untransfused patients (p<0.005). Although patients with comorbidities had a higher transfusion rate than those without, this did not reach statistical significance. Of 120 patients with complete data, 113 (94.2%) had a blood bank order, of which the vast majority, 102/113 (90.3%), were group-and-screen (G&S) requests; 29/113 (25.7%) were converted to a full crossmatch.
Overall, the transfusion rate for both hospitals was 25.8%, which is well within published rates. A guideline Hb trigger of 8.0 g/dL is recommended as per published guidelines, with the caveat that the clinical judgement of the attending clinician whether a transfusion is indicated is paramount. Causes of preoperative anaemia should be investigated and treated. Routine cross-matching preoperatively is unnecessary, and a G&S order is sufficient.</description><identifier>ISSN: 0256-9574</identifier><identifier>ISSN: 2078-5135</identifier><identifier>EISSN: 2078-5135</identifier><identifier>DOI: 10.7196/SAMJ.2016.v106i8.10566</identifier><identifier>PMID: 27499414</identifier><language>eng</language><publisher>South Africa: Health & Medical Publishing Group</publisher><subject>Blood products ; Blood transfusion ; Health aspects ; Health Care Sciences & Services ; Health Policy & Services ; Medical care ; Medical Ethics ; Medicine, General & Internal ; Medicine, Legal ; Medicine, Research & Experimental ; Methods ; Physiological aspects ; Utilization</subject><ispartof>SAMJ: South African Medical Journal, 2016-08, Vol.106 (8), p.824-828</ispartof><rights>COPYRIGHT 2016 Health & Medical Publishing Group</rights><rights>This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,861,882,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27499414$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peters, Yvonne Grace</creatorcontrib><creatorcontrib>Bird, Arthur</creatorcontrib><creatorcontrib>Bellairs, Greg R M</creatorcontrib><creatorcontrib>Davison, Glenda Mary</creatorcontrib><title>A clinical audit of the utilisation of red cell products in elective total hip replacement surgery</title><title>SAMJ: South African Medical Journal</title><addtitle>S Afr Med J</addtitle><description>Previous studies have documented a marked variation in transfusion practice for total hip replacement (THR) surgery.
To audit red cell product utilisation for THR at two Western Cape tertiary referral hospitals (HY and HG).
The folders of 207 consecutive patients undergoing elective THR surgery from January 2013 to December 2013 were reviewed. Information relating to age, sex, clinical observations, indications for surgery, pre- and postoperative haemoglobin (Hb) values, comorbidities, length of hospital stay and transfusion history was recorded.
The transfusion rate at HY (41.6%) was significantly higher than that at HG (10.0%). The mean postoperative Hb in the transfused patients at HG was 8.3 g/dL v. 9.1 g/dL at HY. Females had a significantly higher transfusion rate (33.0%) than males (15.0%) (p<0.05), and the mean age of transfused patients was significantly greater than that of untransfused patients (p<0.005). Although patients with comorbidities had a higher transfusion rate than those without, this did not reach statistical significance. Of 120 patients with complete data, 113 (94.2%) had a blood bank order, of which the vast majority, 102/113 (90.3%), were group-and-screen (G&S) requests; 29/113 (25.7%) were converted to a full crossmatch.
Overall, the transfusion rate for both hospitals was 25.8%, which is well within published rates. A guideline Hb trigger of 8.0 g/dL is recommended as per published guidelines, with the caveat that the clinical judgement of the attending clinician whether a transfusion is indicated is paramount. Causes of preoperative anaemia should be investigated and treated. Routine cross-matching preoperatively is unnecessary, and a G&S order is sufficient.</description><subject>Blood products</subject><subject>Blood transfusion</subject><subject>Health aspects</subject><subject>Health Care Sciences & Services</subject><subject>Health Policy & Services</subject><subject>Medical care</subject><subject>Medical Ethics</subject><subject>Medicine, General & Internal</subject><subject>Medicine, Legal</subject><subject>Medicine, Research & Experimental</subject><subject>Methods</subject><subject>Physiological aspects</subject><subject>Utilization</subject><issn>0256-9574</issn><issn>2078-5135</issn><issn>2078-5135</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqNkktv1DAUhSMEokPhL1SWkBCbBDvxczmqeKqIRWFtOc5Nx5UnHmynUv89Dikws6mQZfmh71zbx6eqLghuBFH83fX265emxYQ3dwRzJxuCGedPqk2LhawZ6djTaoNbxmvFBD2rXqR0i8uaKf68OmsFVYoSuqn6LbLeTc4aj8w8uIzCiPIO0Jydd8lkF6ZlK8KALHiPDjEMs80JuQmBB5vdHaAcctHv3KFwB28s7GHKKM3xBuL9y-rZaHyCVw_jefXjw_vvl5_qq28fP19ur2pLscy1MJL3vRVq6MtMmEFKI7FlZQJKCjGIngCzXYdJR23HW9mLfjCq0EBoP3bnVbPWTdaBD_o2zHEqB-rrxQe9-LAYhjGWpXe0CN6ugvKmnzOkrPcuLY80E4Q5aSIJ7pikghf09YreGA_aTWPI0dgF11vKsSp-Mvk4xZRoKVbq3z1PqNIG2DsbJhhd2T8p-3-CoxPeHAl2YHzepeDn5TPTaeXHwaOKfAVtDClFGPUhur2J95pgvQRSL4HUi796DaT-HcgivHjweO73MPyV_Ulg9ws16tcF</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Peters, Yvonne Grace</creator><creator>Bird, Arthur</creator><creator>Bellairs, Greg R M</creator><creator>Davison, Glenda Mary</creator><general>Health & Medical Publishing Group</general><general>Health and Medical Publishing Group</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>GPN</scope></search><sort><creationdate>20160801</creationdate><title>A clinical audit of the utilisation of red cell products in elective total hip replacement surgery</title><author>Peters, Yvonne Grace ; Bird, Arthur ; Bellairs, Greg R M ; Davison, Glenda Mary</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-7a86bbc79dba867ad88a80c5ad8e9877d7b1e5c330134c3628b7bda9ba8e14bf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Blood products</topic><topic>Blood transfusion</topic><topic>Health aspects</topic><topic>Health Care Sciences & Services</topic><topic>Health Policy & Services</topic><topic>Medical care</topic><topic>Medical Ethics</topic><topic>Medicine, General & Internal</topic><topic>Medicine, Legal</topic><topic>Medicine, Research & Experimental</topic><topic>Methods</topic><topic>Physiological aspects</topic><topic>Utilization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peters, Yvonne Grace</creatorcontrib><creatorcontrib>Bird, Arthur</creatorcontrib><creatorcontrib>Bellairs, Greg R M</creatorcontrib><creatorcontrib>Davison, Glenda Mary</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SciELO</collection><jtitle>SAMJ: South African Medical Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peters, Yvonne Grace</au><au>Bird, Arthur</au><au>Bellairs, Greg R M</au><au>Davison, Glenda Mary</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A clinical audit of the utilisation of red cell products in elective total hip replacement surgery</atitle><jtitle>SAMJ: South African Medical Journal</jtitle><addtitle>S Afr Med J</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>106</volume><issue>8</issue><spage>824</spage><epage>828</epage><pages>824-828</pages><issn>0256-9574</issn><issn>2078-5135</issn><eissn>2078-5135</eissn><abstract>Previous studies have documented a marked variation in transfusion practice for total hip replacement (THR) surgery.
To audit red cell product utilisation for THR at two Western Cape tertiary referral hospitals (HY and HG).
The folders of 207 consecutive patients undergoing elective THR surgery from January 2013 to December 2013 were reviewed. Information relating to age, sex, clinical observations, indications for surgery, pre- and postoperative haemoglobin (Hb) values, comorbidities, length of hospital stay and transfusion history was recorded.
The transfusion rate at HY (41.6%) was significantly higher than that at HG (10.0%). The mean postoperative Hb in the transfused patients at HG was 8.3 g/dL v. 9.1 g/dL at HY. Females had a significantly higher transfusion rate (33.0%) than males (15.0%) (p<0.05), and the mean age of transfused patients was significantly greater than that of untransfused patients (p<0.005). Although patients with comorbidities had a higher transfusion rate than those without, this did not reach statistical significance. Of 120 patients with complete data, 113 (94.2%) had a blood bank order, of which the vast majority, 102/113 (90.3%), were group-and-screen (G&S) requests; 29/113 (25.7%) were converted to a full crossmatch.
Overall, the transfusion rate for both hospitals was 25.8%, which is well within published rates. A guideline Hb trigger of 8.0 g/dL is recommended as per published guidelines, with the caveat that the clinical judgement of the attending clinician whether a transfusion is indicated is paramount. Causes of preoperative anaemia should be investigated and treated. Routine cross-matching preoperatively is unnecessary, and a G&S order is sufficient.</abstract><cop>South Africa</cop><pub>Health & Medical Publishing Group</pub><pmid>27499414</pmid><doi>10.7196/SAMJ.2016.v106i8.10566</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Blood products Blood transfusion Health aspects Health Care Sciences & Services Health Policy & Services Medical care Medical Ethics Medicine, General & Internal Medicine, Legal Medicine, Research & Experimental Methods Physiological aspects Utilization |
| title | A clinical audit of the utilisation of red cell products in elective total hip replacement surgery |
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