RESULTS OF AN ANEMIA PREOPERATIVE?S CIRCUIT CORRECTION AS TECHNIQUE TO SAVE BLOOD IN MAJOR GYNECOLOGICAL SURGERY SINCE 2010 TO 2015 IN A THIRD NEVEL HOSPITAL.
(Abstract release date: 05/19/16)
EHA Library. Garcia Ruiz M. 06/09/16; 135123; PB2223
Dr. Maria Almudana Garcia Ruiz
Contributions
Contributions
Abstract
Abstract: PB2223
Type: Publication Only
Background
Anemia is not only the biggest risk factor for transfusion, but also an independent predictor of perioperative mortality and morbidity, including more infectious complications and increased hospital stay. Its prevalence in surgical patients varies in the range from 10 to 70%, depending on their definition and the type of intervention. Iron-deficiency anemia is the most common cause in the patient's proposal for mayor gynecological surgery (MGS).
Aims
This surgery presents a transfusion rate of 14% and secondary to perioperative anemia without bleeding complications of 13%. Since late 2010, with the creation of a multidisciplinary group of saving blood (PAS). We implemented a circuit for the correction of preoperative anemia in patients scheduled for this surgery with the aim to reduce the rate transfusional. We propose a retrospective study to analyze the effectiveness of this strategy saving blood.
Methods
The proposed patients for MGS with Hb<12 g/dl, we programed, in susceptible cases, the administration of iv iron (sucrose and carboxymaltose) for 2-4 weeks before surgery. The day before the intervention, we monitored a preoperative blood count to assess treatment response and we measured the proportion of transfused patients. 103 patients were included in PAS until February 2015 (Figure 1). 5 patients were transfused: 2 due to hemorrhagic postoperative complications and 3 due to preoperative anemia
Results
Hemoglobin of the patients, which were included in our protocol, an average of 2.46 g / dl and 5.42% hematocrit increased, being the response to treatment statistically significant. We study the evolution of the number of red blood cells concentrates transfused in the gynecology before and after the implementation of our strategy. We observed a decrease of 34.8% in 2010, 22.6% in 2011, 38.4% in 2012, 23.6% in 2013 and 18% in 2014 compared to 2009. (Figure 2). Regarding the incidence of perioperative transfusion, the percentage of patients transfused included in the PAS is 4.9%, while in the historical cohort is 26.5 % and this difference being also statistically significant ( p < 0.001). We compare our patients with a historical cohort obtained from the database at our center, selecting all patients undergoing major surgery gynecological (MSG) available from 2008 to the implementation circuit that meet the same criteria for our group. Preoperative hemoglobin (Hbpre) before (HbprePAS) was analyzed and after our intervention (HbpostPAS), postoperative hemoglobin (HbpostIQ) and the incidence of perioperative transfusion in both groups. Hb levels were compared with a general linear model and the percentage of transfusion with the chi–square test. P value <0.05 was considered significant. The historical cohort was constituted with 223 patients. Before treatment with iv iron patients exhibit inferior circuit Hbpre the cohort historical statistically significant (p <0.001). After PAS, the change in Hb is statistically significant (p <0.001), so that the Hbpre of treated patients is 12.7 g / dl versus 11.14 g / dl group untreated. The average value of the HbpostQ is also superior in our group significantly (p <0.001). Figure 3.
Conclusion
This circuit is effective to correct the preoperative anemia of the patients proposed for MSG. This protocol has improved Hb levels and preoperative hematocrit of these patients. The results were statistically significant. Treatment with intravenous iron for the correction of preoperative anemia in GMS as blood conservation strategy is effective to increase Hbpre statistically significant. Patients included in the circuit have a lower incidence of transfusion and have greater HbpostQI that patients not treated with iv iron. This protocol has improved Hb levels and preoperative hematocrit of these patients. The results were statistically significant. This measure seems effective in reducing the transfusion risk.
Session topic: E-poster
Keyword(s): Anemia, Iron deficiency anemia, Transfusion
Type: Publication Only
Background
Anemia is not only the biggest risk factor for transfusion, but also an independent predictor of perioperative mortality and morbidity, including more infectious complications and increased hospital stay. Its prevalence in surgical patients varies in the range from 10 to 70%, depending on their definition and the type of intervention. Iron-deficiency anemia is the most common cause in the patient's proposal for mayor gynecological surgery (MGS).
Aims
This surgery presents a transfusion rate of 14% and secondary to perioperative anemia without bleeding complications of 13%. Since late 2010, with the creation of a multidisciplinary group of saving blood (PAS). We implemented a circuit for the correction of preoperative anemia in patients scheduled for this surgery with the aim to reduce the rate transfusional. We propose a retrospective study to analyze the effectiveness of this strategy saving blood.
Methods
The proposed patients for MGS with Hb<12 g/dl, we programed, in susceptible cases, the administration of iv iron (sucrose and carboxymaltose) for 2-4 weeks before surgery. The day before the intervention, we monitored a preoperative blood count to assess treatment response and we measured the proportion of transfused patients. 103 patients were included in PAS until February 2015 (Figure 1). 5 patients were transfused: 2 due to hemorrhagic postoperative complications and 3 due to preoperative anemia
Results
Hemoglobin of the patients, which were included in our protocol, an average of 2.46 g / dl and 5.42% hematocrit increased, being the response to treatment statistically significant. We study the evolution of the number of red blood cells concentrates transfused in the gynecology before and after the implementation of our strategy. We observed a decrease of 34.8% in 2010, 22.6% in 2011, 38.4% in 2012, 23.6% in 2013 and 18% in 2014 compared to 2009. (Figure 2). Regarding the incidence of perioperative transfusion, the percentage of patients transfused included in the PAS is 4.9%, while in the historical cohort is 26.5 % and this difference being also statistically significant ( p < 0.001). We compare our patients with a historical cohort obtained from the database at our center, selecting all patients undergoing major surgery gynecological (MSG) available from 2008 to the implementation circuit that meet the same criteria for our group. Preoperative hemoglobin (Hbpre) before (HbprePAS) was analyzed and after our intervention (HbpostPAS), postoperative hemoglobin (HbpostIQ) and the incidence of perioperative transfusion in both groups. Hb levels were compared with a general linear model and the percentage of transfusion with the chi–square test. P value <0.05 was considered significant. The historical cohort was constituted with 223 patients. Before treatment with iv iron patients exhibit inferior circuit Hbpre the cohort historical statistically significant (p <0.001). After PAS, the change in Hb is statistically significant (p <0.001), so that the Hbpre of treated patients is 12.7 g / dl versus 11.14 g / dl group untreated. The average value of the HbpostQ is also superior in our group significantly (p <0.001). Figure 3.
Conclusion
This circuit is effective to correct the preoperative anemia of the patients proposed for MSG. This protocol has improved Hb levels and preoperative hematocrit of these patients. The results were statistically significant. Treatment with intravenous iron for the correction of preoperative anemia in GMS as blood conservation strategy is effective to increase Hbpre statistically significant. Patients included in the circuit have a lower incidence of transfusion and have greater HbpostQI that patients not treated with iv iron. This protocol has improved Hb levels and preoperative hematocrit of these patients. The results were statistically significant. This measure seems effective in reducing the transfusion risk.
Session topic: E-poster
Keyword(s): Anemia, Iron deficiency anemia, Transfusion
Abstract: PB2223
Type: Publication Only
Background
Anemia is not only the biggest risk factor for transfusion, but also an independent predictor of perioperative mortality and morbidity, including more infectious complications and increased hospital stay. Its prevalence in surgical patients varies in the range from 10 to 70%, depending on their definition and the type of intervention. Iron-deficiency anemia is the most common cause in the patient's proposal for mayor gynecological surgery (MGS).
Aims
This surgery presents a transfusion rate of 14% and secondary to perioperative anemia without bleeding complications of 13%. Since late 2010, with the creation of a multidisciplinary group of saving blood (PAS). We implemented a circuit for the correction of preoperative anemia in patients scheduled for this surgery with the aim to reduce the rate transfusional. We propose a retrospective study to analyze the effectiveness of this strategy saving blood.
Methods
The proposed patients for MGS with Hb<12 g/dl, we programed, in susceptible cases, the administration of iv iron (sucrose and carboxymaltose) for 2-4 weeks before surgery. The day before the intervention, we monitored a preoperative blood count to assess treatment response and we measured the proportion of transfused patients. 103 patients were included in PAS until February 2015 (Figure 1). 5 patients were transfused: 2 due to hemorrhagic postoperative complications and 3 due to preoperative anemia
Results
Hemoglobin of the patients, which were included in our protocol, an average of 2.46 g / dl and 5.42% hematocrit increased, being the response to treatment statistically significant. We study the evolution of the number of red blood cells concentrates transfused in the gynecology before and after the implementation of our strategy. We observed a decrease of 34.8% in 2010, 22.6% in 2011, 38.4% in 2012, 23.6% in 2013 and 18% in 2014 compared to 2009. (Figure 2). Regarding the incidence of perioperative transfusion, the percentage of patients transfused included in the PAS is 4.9%, while in the historical cohort is 26.5 % and this difference being also statistically significant ( p < 0.001). We compare our patients with a historical cohort obtained from the database at our center, selecting all patients undergoing major surgery gynecological (MSG) available from 2008 to the implementation circuit that meet the same criteria for our group. Preoperative hemoglobin (Hbpre) before (HbprePAS) was analyzed and after our intervention (HbpostPAS), postoperative hemoglobin (HbpostIQ) and the incidence of perioperative transfusion in both groups. Hb levels were compared with a general linear model and the percentage of transfusion with the chi–square test. P value <0.05 was considered significant. The historical cohort was constituted with 223 patients. Before treatment with iv iron patients exhibit inferior circuit Hbpre the cohort historical statistically significant (p <0.001). After PAS, the change in Hb is statistically significant (p <0.001), so that the Hbpre of treated patients is 12.7 g / dl versus 11.14 g / dl group untreated. The average value of the HbpostQ is also superior in our group significantly (p <0.001). Figure 3.
Conclusion
This circuit is effective to correct the preoperative anemia of the patients proposed for MSG. This protocol has improved Hb levels and preoperative hematocrit of these patients. The results were statistically significant. Treatment with intravenous iron for the correction of preoperative anemia in GMS as blood conservation strategy is effective to increase Hbpre statistically significant. Patients included in the circuit have a lower incidence of transfusion and have greater HbpostQI that patients not treated with iv iron. This protocol has improved Hb levels and preoperative hematocrit of these patients. The results were statistically significant. This measure seems effective in reducing the transfusion risk.
Session topic: E-poster
Keyword(s): Anemia, Iron deficiency anemia, Transfusion
Type: Publication Only
Background
Anemia is not only the biggest risk factor for transfusion, but also an independent predictor of perioperative mortality and morbidity, including more infectious complications and increased hospital stay. Its prevalence in surgical patients varies in the range from 10 to 70%, depending on their definition and the type of intervention. Iron-deficiency anemia is the most common cause in the patient's proposal for mayor gynecological surgery (MGS).
Aims
This surgery presents a transfusion rate of 14% and secondary to perioperative anemia without bleeding complications of 13%. Since late 2010, with the creation of a multidisciplinary group of saving blood (PAS). We implemented a circuit for the correction of preoperative anemia in patients scheduled for this surgery with the aim to reduce the rate transfusional. We propose a retrospective study to analyze the effectiveness of this strategy saving blood.
Methods
The proposed patients for MGS with Hb<12 g/dl, we programed, in susceptible cases, the administration of iv iron (sucrose and carboxymaltose) for 2-4 weeks before surgery. The day before the intervention, we monitored a preoperative blood count to assess treatment response and we measured the proportion of transfused patients. 103 patients were included in PAS until February 2015 (Figure 1). 5 patients were transfused: 2 due to hemorrhagic postoperative complications and 3 due to preoperative anemia
Results
Hemoglobin of the patients, which were included in our protocol, an average of 2.46 g / dl and 5.42% hematocrit increased, being the response to treatment statistically significant. We study the evolution of the number of red blood cells concentrates transfused in the gynecology before and after the implementation of our strategy. We observed a decrease of 34.8% in 2010, 22.6% in 2011, 38.4% in 2012, 23.6% in 2013 and 18% in 2014 compared to 2009. (Figure 2). Regarding the incidence of perioperative transfusion, the percentage of patients transfused included in the PAS is 4.9%, while in the historical cohort is 26.5 % and this difference being also statistically significant ( p < 0.001). We compare our patients with a historical cohort obtained from the database at our center, selecting all patients undergoing major surgery gynecological (MSG) available from 2008 to the implementation circuit that meet the same criteria for our group. Preoperative hemoglobin (Hbpre) before (HbprePAS) was analyzed and after our intervention (HbpostPAS), postoperative hemoglobin (HbpostIQ) and the incidence of perioperative transfusion in both groups. Hb levels were compared with a general linear model and the percentage of transfusion with the chi–square test. P value <0.05 was considered significant. The historical cohort was constituted with 223 patients. Before treatment with iv iron patients exhibit inferior circuit Hbpre the cohort historical statistically significant (p <0.001). After PAS, the change in Hb is statistically significant (p <0.001), so that the Hbpre of treated patients is 12.7 g / dl versus 11.14 g / dl group untreated. The average value of the HbpostQ is also superior in our group significantly (p <0.001). Figure 3.
Conclusion
This circuit is effective to correct the preoperative anemia of the patients proposed for MSG. This protocol has improved Hb levels and preoperative hematocrit of these patients. The results were statistically significant. Treatment with intravenous iron for the correction of preoperative anemia in GMS as blood conservation strategy is effective to increase Hbpre statistically significant. Patients included in the circuit have a lower incidence of transfusion and have greater HbpostQI that patients not treated with iv iron. This protocol has improved Hb levels and preoperative hematocrit of these patients. The results were statistically significant. This measure seems effective in reducing the transfusion risk.
Session topic: E-poster
Keyword(s): Anemia, Iron deficiency anemia, Transfusion
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